Kamata T, Ogawa Y, Iguchi Y, Nakamura Y, Mochizuki T
Department of Otolaryngology, Yokosuka City Hospital, Kanagawa.
Nihon Jibiinkoka Gakkai Kaiho. 1995 Jul;98(7):1119-24. doi: 10.3950/jibiinkoka.98.1119.
We report a recently encountered case of vascular leiomyoma in the larynx. The patient was a 76-year-old man with a chief complaint of hoarseness. Laryngoscopy revealed a bean-sized, reddish tumor with a smooth surface, suspended from the right vocal cord toward the subglottis. Its border was clear on MR imaging. Tracheotomy was performed under local anesthesia, and laryngomicrosurgery was then carried out under general anesthesia. The tumor was encapsulated and could be completely resected. Histological study indicated smooth muscule cell proliferation, especially around capillaries, and the tumor was diagnosed as a vascular leiomyoma. Our extensive survey of the literature revealed 20 reports of benign myogenic tumor of the larynx (9 cases of simple leiomyoma, 10 of vascular leiomyoma, and 1 of leiomyoblastoma), many of which occurred in the middle and advanced years. The patients consisted of 15 men and 5 women, including 9 male vascular leiomyoma patients of middle or advanced age. The site of occurrence was supraglottic in 12, glottic in 4 and subglottic in 4; no relation was observed with the histological picture, however. Treatment was surgical, and some cases also required tracheotomy depending on the site of occurrence and morphology.
我们报告了一例最近遇到的喉部血管平滑肌瘤病例。患者为一名76岁男性,主要症状为声音嘶哑。喉镜检查发现一个豆粒大小、表面光滑的红色肿瘤,从右侧声带向声门下区悬垂。其边界在磁共振成像上清晰可见。在局部麻醉下进行了气管切开术,随后在全身麻醉下进行了喉显微手术。肿瘤有包膜,可完全切除。组织学研究显示平滑肌细胞增生,尤其是在毛细血管周围,该肿瘤被诊断为血管平滑肌瘤。我们对文献的广泛检索发现了20例喉部良性肌源性肿瘤的报告(9例单纯平滑肌瘤、10例血管平滑肌瘤和1例成肌细胞瘤),其中许多发生在中年及老年。患者包括15名男性和5名女性,其中有9名中老年男性血管平滑肌瘤患者。发生部位为声门上区12例、声门区4例和声门下区4例;然而,与组织学表现无关。治疗方法为手术,部分病例还需根据发生部位和形态进行气管切开术。