Adenoid cystic carcinoma of the larynx in a 70-year-old patient: A case report

Abstract

Adenoid cystic carcinoma (ACC) is a relatively rare tumor that accounts for <1% of all head and neck malignancies. Laryngeal localization of ACC, which is most commonly hypoglottic, is relatively rare, occurring in 0.07-0.25% of all laryngeal tumors. ACC is characterized as a slow-growing tumor with a high recurrence rate, which often causes dyspnea and hoarseness. ACC exhibits a propensity for perineural invasion and thus, patients may experience pain as a late symptom of the disease. Distant metastasis occurs in 35-50% of cases and the lungs are the most common site of metastasis. Tumors are usually diagnosed by physical examination with fiberoscopy and computed tomography of the neck and chest, due to the high rate of lung metastases. The standard therapy for ACC is surgery followed by radiotherapy. In this study, a 70-year-old patient presented with laryngeal ACC, who underwent total laryngectomy with bilateral neck dissection and adjuvant radiotherapy, is presented. Follow-up examination performed 2 years after surgery revealed no evidence of locoregional recurrence or distant metastases. Previously published literature regarding ACC of the larynx was also reviewed.

Keywords: adenoid cystic carcinoma; epidermal growth factor receptor; laryngectomy; radiotherapy.

Figure 1.

Laryngoscopy revealed a bulging mass in the left true vocal cord and left ventricle extending to the subglottic area with fixity of the left larynx.

Figure 2.

Total body positron emission tomography-computed tomography with contrast medium revealed hyperaccumulation of tracer in the left laryngeal region (standardized uptake volume, 7.9).

Figure 3.

Neck magnetic resonance imaging with contrast medium revealed asymmetric reduction of the laryngeal glottic plane due to the presence of a solid, inhomogeneous lesion. Increased perfusion was observed predominantly in the left true vocal cord (28×37 mm).

Figure 4.

Hematoxylin/eosin staining of an adenoid cystic carcinoma. Magnification, ×10.