Rhabdomyoma purum of the larynx.

A case of pure well-differentiated rhabdomyoma of the larynx occurring in a 50-year-old male is reported. The lesion was localized to the interarytenoid region. From an accurate revision of the world literature on the subject it appears that the cases so far described number only seven, including the one in the present report. Furthermore, the differential histological and histochemical criteria for distinguishing rhabdomyoma from granular cell Schwannoma are discussed and tabulated, as the two neoplasms may be easily confused. In our case, there has been no evidence of recurrence of the tumour for more than 1 year, which is in accordance with the previous cases reported in the literature.     

Rhabdomyoma of the larynx

Since 1897 a total of 37 cases of extracardiac rhabdomyomas of the fetal type have been reported in the literature. Only two of these were localized in the larynx. We report an additional case of extracardiac rhabdomyoma localized in the larynx, and the pertinent literature is discussed. Although rare, its existence should be kept in mind in the differential diagnosis of laryngeal tumours.     

Adult rhabdomyoma of the larynx.

A case of rhabdomyoma of the larynx in a 76-year-old woman patient is reported. The tumor was localized on the left vocal cord. This case is, so far described, the seventh one of adult rhadbomyoma of the larynx. The differential histological and histochemical diagnosis with granular cell myoblastoma is discussed and tabulated. Both tumors can easily be confused. In accordance with previously reported cases no evidence of recurrence after more than two years could be observed.     

Adult rhabdomyoma of the larynx

Summary A case of rhabdomyoma of the larynx in a 76-year-old women patient is reported. The tumor was localized on the left vocal cord. This case is, so far described, the seventh one of adult rhabdomyoma of the larynx. The differential histological and histochemical diagnosis with granular cell myoblastoma is discussed and tabulated. Both tumors can easily be confused. In accordance with previously reported cases no evidence of recurrence after more than two years could be observed.     

Submandibular rhabdomyoma.

A case of recurrent adult rhabdomyoma of the submandibular gland is presented. This is a rare tumor of the skeletal muscle. Approximately 80 cases have been reported. The salient pathologic features are reviewed and a discussion and review of the literature is presented.     

Myogenic tumours of the larynx

Summary The pathology and clinical course of the very rare tumours of the smooth and striated muscles of the larynx are described. The literature is reviewed and personal cases of angioleiomyoma, leiomyosarcomas, rhabdomyoma, and rhabdomyosarcoma are reported.     

Differential diagnosis of cervical space occupying lesion: the parapharyngeal rhabdomyoma]

A case of a parapharyngeal rhabdomyoma is presented. Only about 30 cases of this benign tumor of striated muscles are reported in the literature. Most tumors were located in the lateral cervical region. Histologically a rhabdomyoma must be distinguished from other mesenchymal tumors, especially from granular cell myoblastoma, hibernoma and reticulohistiocytoma. The value of magnetic resonance imaging in the radiological evaluation of parapharyngeal masses is emphasized. Operative resection is generally regarded as the therapy of choice. Local recurrences have been reported in some cases; malignant degeneration is not known.     

Multifocal adult rhabdomyoma of the neck: a rare entity

Extracardiac rhabdomyoma comprise 2% of all tumors of skeletal muscle differentiation. Seventy percent of extracardiac rhabdomyoma occur in the head and neck region and have been subclassified into adult and fetal types. There are only about 100 cases reported in the literature. A review of the world literature revealed about 19 acceptable cases of benign, multifocal adult-type rhabdomyoma with a distinct male predominance. The pathogenesis of this benign striated muscle tumor is still unclear. These slow-growing tumors remain asymptomatic for a long period. The diagnosis of head and neck rhabdomyoma is based on histology and immunhistochemical studies. The differential diagnoses of rhabdomyoma in adults are myoblastoma or Abrikossof tumor, reticulohistiocytoma, rhabdomyosarcoma and hibernoma. We present a case of multifocal rhabdomyomas in the paratracheal and parapharyngeal space and discuss the clinicopathological features of this lesion. Although adult rhabdomyomas have a distinct histology, they often are mistaken for a variety of other lesions, particularly Abrikossof tumor. Light microscopy showed large round to elongated cells with granular, highly eosinophilic cytoplasm, often with peripheral vacuolation. Histology showed typical patterns of an adult type of rhabdomyoma with focal cross-striations. Immunhistochemically, all applied muscular markers were positive. Electron microscopic studies confirmed the tumor's myogenic origin. Myofibrils with Z band material, abundant mitochondria and glycogen particles were observed. Treatment is usually complete excision. Local recurrences have been reported in some cases; malignant degeneration is not known.     

Primary rhabdomyosarcoma of the larynx

Sarcomas constitute fewer than 1% of the head and neck cancers. They represent less than 1% of laryngeal cancers. Primary rhabdomyosarcoma of the larynx is an extremely rare malignancy. The available literature on this medical oddity is in the form of isolated case reports only. The purpose of this article is to add another case of primary rhabdomyosarcoma of a rare site, the larynx, of which only 36 cases have so far been reported in the world literature. The present patient, an eighteen-year-old boy is only the third case being reported from India among all reported cases of rhabdomyosarcoma of the larynx in the world literature.     

Oncocytic papillary cystadenomatosis of the larynx.

Symptomatic oncocytic disease of the larynx is rare. Review of the world literature reveals that isolated, symptomatic cases of oncocytoma of the larynx have been previously reported to involve discrete sites usually the laryngeal ventricles and vestibular folds. A unique case of multifocal cystic oncocytic hyperplasia necessitating laryngectomy is reported. CT scan of the larynx suggested destruction of the cartilage. Malignant histological features were not present. This report raises the question whether previously described cases of oncocytoma of the larynx also had diffuse involvement. If oncocytosis is a diffuse process then it is suggested that patients should be kept under review for recurring lesions.     

Pleomorphic adenoma of the epiglottis.

Pleomorphic adenoma is the most common benign tumor of the major salivary glands. A pleomorphic adenoma in the larynx constitutes a rarity. A small number of cases have been reported in the literature. We report on a case seen in our hospital, and have reviewed those cases published in the medical literature during the last 25 years.     

Extracardiac juvenile rhabdomyoma of the larynx: a rare pathological finding

The extracardiac juvenile rhabdomyoma is extremely rare in the field of Otorhinolaryngology. The tumour usually arises from the soft tissue of the face or from mucosal sites, especially the oropharynx and the oral cavity but only sporadic endolaryngeal cases have been described in literature so far with predominance of young males. Here, we describe the very rare case of endolaryngeal extracardiac juvenile rhabdomyoma in a 42-year-old male. Clinical examination showed a mass of the right vocal cord, resembling a cystic lesion. Microlaryngoscopy revealed a non-encapsulated lesion and histopathology including immunohistochemistry which consecutively led to the correct diagnosis. This case suggests that the endolaryngeal extracardiac juvenile rhabdomyoma can be easily confused with a vocal cord cyst. Malignant transformations have not been reported but recurrences have been described. When total excision cannot be accomplished, reoperation or narrow follow-up is indicated to prevent advanced revision surgeries.     

Composite tumor of the larynx.

Composite tumor of the larynx has been described as a mixed squamous cell and oat cell carcinoma originating in the larynx. Only eight cases of composite tumor of the larynx have been described in the world medical literature. We present the ninth case ever reported. Therapy for this very aggressive malignancy is with a combined approach--surgery, radiation, and chemotherapy. A common etiology for both squamous cell and oat cell carcinoma has been proposed. Recommendations for diagnostic evaluation as well as therapeutic intervention will be discussed.     

Liposarcoma of the larynx

Liposarcomas of the larynx are very rare. Only nine cases appear to have been recorded in the English literature. An additional case of liposarcoma of the larynx occurring in a young patient is reported and the relevant literature discussed.     

Adult rhabdomyoma in the parapharyngeal space: report of 2 cases and review of the literature

Rhabdomyomas are rare benign mesenchymal tumors with skeletal muscle differentiation. They are less commonly encountered than are their malignant counterparts, rhabdomyosarcomas. Rhabdomyomas fall into 2 general categories: cardiac and extracardiac types. Extracardiac rhabdomyomas are among the rarest tumors in humans and can be subclassified as fetal, juvenile, and adult types depending on the individual tumor's degree of differentiation by light microscopy. Adult extracardiac rhabdomyoma has a strong predilection for occurrence in the head and neck, mainly in the area of larynx and pharynx. In this article, 2 cases of parapharyngeal rhabdomyoma are reported together with a review of the world literature.     

Actinomycosis of the larynx.

Actinomycosis of the larynx is rare. Only seven cases have been reported in the literature. We report a case of actinomycosis of the larynx in a 63-year-old male following radiation therapy for laryngeal carcinoma. The diagnosis of actinomycosis can be made with a biopsy. It is important to distinguish infection from radionecrosis and recurrent carcinoma. Treatment consists of airway control and a prolonged course of antibiotics.     

Rhabdomyoma of the cricopharyngeus in an infant

Rhabdomyoma is a rare benign tumor characterized histologically by striated skeletal muscle. Rhabdomyomas can be classified into adult and fetal variants. The majority of adult variants arise in the head and neck region and are derived from the skeletal muscles of the pharyngeal (branchial) arches. The majority of cases of fetal variant rhabdomyomas have been described in the postauricular region of young children and the vulvovaginal region in middle-aged women. We present a case of a 15-month-old infant with a circumferential rhabdomyoma of the cricopharyngeus muscle requiring excision of the esophageal inlet and reconstruction with a free microvascular jejunal interposition graft. This case represents the youngest reported case of adult variant rhabdomyoma. The clinical, radiographic, and histologic findings of this unusual case and a review of reported cases of rhabdomyoma in the pediatric population will be presented.     

Osteochondroma of the larynx

Benign cartilaginous tumours of the larynx and trachea are rare. The most common is chondroma, and only 6 cases of osteochondroma of the larynx have been reported in the world literature. We present a case of 74 year's old woman with osteochondroma of the right arytenoid cartilage. This is followed by a review of the literature, diagnostic evaluation and surgical management.     

Rectal adenocarcinoma metastatic to the larynx

Malignancies metastatic to the larynx are rare, accounting for fewer than 1% of all laryngeal cancers with metastatic sources; the most common of these metastases are cutaneous melanomas and renal cell carcinomas. Only 13 cases of colon cancer and 2 cases of rectal adenocarcinoma metastatic to the larynx have been previously reported in the literature. We report a new case of rectal adenocarcinoma metastatic to the larynx that resulted in subglottic stenosis in a 60-year-old man. We also review the literature, and we discuss the presentations of and treatments for this rare entity.     

Delayed radionecrosis of the larynx.

Radiation has been used to treat carcinoma of the larynx for more than 70 years. Radionecrosis is a well-known complication of this modality when treating head and neck neoplasms. It has been described in the temporal bone, midface, mandible, and larynx. Laryngeal radionecrosis is manifested clinically by dysphagia, odynophagia, respiratory obstruction, hoarseness, and recurrent aspiration. The vast majority of patients who develop laryngeal radionecrosis present with these symptoms within 1 year of treatment; however, delayed presentations have been reported up to 25 years after radiotherapy. We present, in a retrospective case analysis, an unusual case of laryngeal radionecrosis in a patient who presented more than 50 years after treatment with radiotherapy for carcinoma of the larynx. The cases of delayed laryngeal necrosis in the literature are presented. This represents the longest interval between treatment and presentation in the literature. The details of the presentation, clinical course, and diagnostic imaging are discussed. The pathogenesis, clinical features, and treatment options for this rare complication are reviewed. Early stage (Chandler I and II) laryngeal radionecrosis may be treated conservatively and often observed. Late stage (Chandler III and IV) cases are medical emergencies, occasionally resulting in significant morbidity or mortality. Aggressive diagnostic and treatment measures must be implemented in these cases to improve outcome. This case represents the longest interval between initial treatment and presentation of osteoradionecrosis in the literature. A structured diagnostic and therapeutic approach is essential in managing this difficult problem.