Escher A, Escher F, Zimmermann A
HNO. 1984 Jul;32(7):269-85.
Two cases of chondroma of the larynx are presented: After the first laryngofissure and excision both tumours recurred so that several operations became necessary. A transformation from chondroma to chondrosarcoma was observed based on repeated histological examinations. In the first patient pulmonary metastases and a recurrence at the tracheostomy appeared 11 years after presentation and 41/2 years after laryngectomy. In the other female patient no obvious signs of the neoplasm are present 9 years after presentation, and 4 months after the last operation for recurrence, but the prognosis remains undetermined. 101 cases of chondrosarcoma from the literature plus our 2 observations are listed and compared with 130 chondrosarcomas of the skeleton. Contrary to previous opinions, we conclude that chondrosarcoma of the larynx behaves in the same malignant manner as those of the skeleton. Some develop metastases quickly, others only after years and after at least one operation for recurrence. We could demonstrate that a detailed histological examination allows the prognosis to be assessed. Additional risk factors were also investigated. These two cases enable a better and more reliable judgement to be made of the prospective biological behaviour of chondromatous tumours of the larynx and at an earlier period of time of the process.
首例患者在首次喉裂开及切除术后肿瘤复发,因此需要进行多次手术。基于反复的组织学检查,观察到了从软骨瘤向软骨肉瘤的转变。首例患者在就诊11年后、喉切除术后4年半出现肺转移及气管造口处复发。另一例女性患者在就诊9年后、最后一次复发手术后4个月未出现明显肿瘤迹象,但预后仍不确定。列出了文献中的101例软骨肉瘤以及我们的2例观察病例,并与130例骨骼软骨肉瘤进行了比较。与以往观点相反,我们得出结论,喉软骨肉瘤的恶性行为与骨骼软骨肉瘤相同。一些患者很快发生转移,另一些则在数年之后且至少经过一次复发手术后才发生转移。我们能够证明详细的组织学检查有助于评估预后。还研究了其他危险因素。这两例病例能够在更早的病程阶段对喉软骨瘤性肿瘤的未来生物学行为做出更好、更可靠的判断。