Primary glottic malignant melanoma of the larynx (PGMML): a very rare entity

Abstract

Primary glottic malignant melanoma of the larynx (PGMML) is a very rare clinical entity with less than 20 cases reported in the literature so far. The most frequently reported subsite in primary malignant melanomas of the larynx is the supraglottic larynx. The vocal cord as a subsite for primary malignant melanoma is very rare. The present case is a primary glottic malignant melanoma involving both vocal cords. PGMML may present early due to associated hoarseness of voice, unlike other non-cutaneous melanomas in the head and neck. Non-cutaneous malignant melanomas in the head and neck are historically very aggressive in nature and known for poor outcomes and survival. Most non-cutaneous melanomas described in the literature have been superficial spreading or ulcerative in nature, unlike the present case, in which proliferative, polypoidal growth was seen. No associated risk factor was present in this case. Every reported case of this rare entity further adds to the better understanding of tumour biology and expression.

Figure 1

Direct laryngoscopy findings: pigmented, polypoidal growth involving both vocal cords and extending to the vestibular folds.

Figure 2

Photomicrograph showing H&E staining (×200): pleomorphic picture of polygonal cells interspersed with spindle cells.

Figure 3

Immunohistochemistry showing diffuse positivity for Melan A, HMB-45, S100 and vimentin.