Laryngeal chondrosarcoma, case report and literature review

Abstract

Introduction: Chondrosarcoma constitutes 0.2% of all malignant tumors of the larynx. Many surgeons treat it with total laryngectomy due to the limited experience with this neoplasm because its rarity, and although several conservative approaches have been proposed, the data of these techniques are limited and based on retrospective series.

Presentation of case: A 52-year-old male with a transglottic submucosal tumor and glottic stenosis in fiberoptic examination showed by tomography a laryngeal tumor that infiltrates vocal cords, glottis, cricoid and thyroid cartilage of 3 × 2.7 × 4 cm. Patient was submitted to total laryngectomy with selective bilateral neck dissection because obstructive tumor. Pathology reported a cricoid cartilage tumor consistent with grade 2 chondrosarcoma.

Discussion: Biopsy by laryngoscopy is considered the standard procedure for the diagnosis of laryngeal tumors, however the need for general anesthesia and the difficulty in intubation in some patients with large tumors make difficult to obtain an adequate biopsy in some cases with submucosal tumor. Conservative surgeries should be individualized based on the size and location of the tumor as well as on the patient's general conditions. Radical treatment is recommended for high-grade and large tumors in which conservative surgery would destabilize the cricoid ring.

Conclusion: There is no diagnostic and treatment approach established for laryngeal chondrosarcoma, we believe that percutaneous biopsy would be the diagnostic test of choice because it is less invasive and has a high sensitivity and specificity; it could also identify patients who are candidates for conservative surgeries.

Keywords: Case report; Chondrosarcoma; Laryngeal chondrosarcoma; Laryngeal sarcoma; Laryngeal tumor; Sarcoma.

Fig. 1

CT scan: Neoplasm in larynx that infiltrates vocal cords and part of the glottis as well as cricoid cartilage and right lateral part of the thyroid with dimensions of 3 x 2.7 cm on its axial axis and a craniocaudal extension of 4 cm.

Fig. 2

Glottic stenosis due to lesion covered by normal appearance mucosa with subglottic extension. The tumor apparently originates from the cricoid cartilage, has a solid surface, bright, white and measures 3.5 × 2 × 2 cm. The tumor expands the cartilage and infiltrates the mucosa without ulcerating it and infiltrates both paraglottic spaces with the pre-epiglottic space free of tumor.