Unique presentation of adenoid cystic carcinoma in postcricoid region: a case report and review of the literature

Abstract

Malignant tumors of minor salivary glands are uncommon, representing only 2-4% of all head and neck malignancies. In the larynx, minor salivary gland tumors rarely occur and constitute less than 1% of laryngeal tumors. Most of the minor salivary gland tumors arise in the subglottis; however, they can also occur in the supraglottis in the false vocal cords, aryepiglottic folds, and caudal aspect of the epiglottis. The most common type of malignant minor salivary gland tumor is adenoid cystic carcinoma. In the last 20 years, only 40 cases of adenoid cystic carcinoma arising in variable locations of the larynx have been reported in the English language literature. We present a case of adenoid cystic carcinoma of the larynx arising in the inter-arytenoid and postcricoid region in a 54-year-old woman. To our knowledge, this is the first case of adenoid cystic carcinoma arising in this particular region of the larynx.

Fig. 1

Macroscopic appearance of the tumor in the inter-arytenoid, postcricoid area. Note the large glistening, submucosal mass bulging into the laryngeal space and causing mass effect in the hypopharynx, which explains the patient’s history of dysphagia

Fig. 2

Bisection reveals a tan-white glistening cut surface with minute focal hemorrhage (greater on the right)

Fig. 3

Microscopic appearance of AdCC shows classic cribriform architecture and small, bland hyperchromatic cells forming pseudoglandular spaces filled with a mucinous, pink to pale purple basement membrane-like material. Occasional small true glandular spaces are also seen. Perineural invasion (not shown) was identified only in the resected specimen