Cryptococcosis of the larynx.

An unusual case of cryptococcosis of the larynx initially developed as an acute upper airway obstruction that necessitated tracheostomy. Concomitant findings were tracheobronchial ulcerations and edema with severe mainstem bronchial constriction on the left side. Budding "yeast-like organisms" that were consistent with Cryptococcus neoformans appeared in tissue specimens. Epithelial changes that were consistent with pseudoepitheliomatous hyperplasia occurred in areas in the immediate vicinity of the organisms. Sputum and bronchial washing cultures grew nonmycelial, mucinous, encapsulated forms that were positive to staining with mucicarmine and Alcian blue. Treatment with amphotericin B resulted in resolution of the laryngeal obstruction, permitting decannulation. Follow-up direct laryngoscopy and biopsy three months after completion of therapy revealed only mild edema of the false vocal folds. No organisms were found in the tissue, and the pseudoepitheliomatous hyperplastic mucosal changes had resolved.     

Hemangiopericytoma of the larynx

Hemangiopericytomas are rare vascular neoplasms of the head and neck. Laryngeal involvement is even more rare, with only 9 previously reported cases in the literature. We present an unusual case of a 46 year old with a supraglottic hemangiopericytoma treated surgically. We will review the clinical features and treatment of hemangiopericytomas, as well as a review of the literature. Otolaryngologists need to be aware of this rare tumor that can be treated successfully with surgical resection. Close long-term follow up is needed since recurrence can present many years after initial treatment.     

Hamartoma of the larynx

A patient with a small mass occupying the laryngeal ventricle is reported. The rare histological diagnosis of an epithelial hamartoma is discussed, with reference to the other sites of occurrence in the head and neck.     

Actinomycosis of the larynx

Actinomycosis is a disease characterized by a chronic suppurative and granulomatous process which tends to form multiple pyogenic draining sinus tracts. The most common site in which it occurs is the cervico-facial region, especially in the submandibular area. The exudates from the fistulous tracts usually contain yellow granules known as "sulfur granules," which can be considered as a hallmark of actinomycosis. We report a rare case of laryngeal actinomycosis which occurred in a 68-year-old male who had been irradiated 8 years before due to laryngeal carcinoma. During the admission, the patient was also diagnosed as being a myelodisplastic syndrome carrier. The patient was treated successfully with penicillin 10 million IU administered daily over 40 days. The etiologic agents, predisposing factors, diagnostic procedures, and available treatments are discussed, and the pertinent literature is reviewed herein.     

Fibrosarcoma of the larynx

Fibrosarcoma is the most common neoplasm of the larynx of mesenchymal origin. Between 1991 and 1996 three cases of fibrosarcoma were observed in the ENT Clinic of the Pomeranian Medical Academy. There were two males and one female aged 49-66. It makes 0.5% (3 in 655 cases) of all malignant neoplasms of the larynx treated by surgery in the mentioned period of time. The primary focus of the neoplasm in one case was located in anterior commissure and in the two others--in the vocal cord. In all the cases surgery was done. Results of the treatment were given.     

Chondroma of the larynx

Chondroid tumors of the larynx are extremely rare and their develope and symptoms are difficult to diagnosis. The importance of well radiological diagnosis prior chirurgical treatment of chondroid tumors of the larynx is empasised. Conservative surgical management when possible, is advocated to preserve the larynx. We presented a case of chondroma of cricoid cartilage developing in 49-year old woman with 4 year history of hoarsness, treated by surgical management - laryngofissure. During 36 months follow up no reccurency is observed. In the paper review of literarature is presented.     

Chemodectoma of the larynx

Chemodectomas of the larynx are rare tumors. Only 35 cases were reported in the literature prior to the publication of this paper. We report a further case and discuss the problems associated with hemorrhage during surgery.     

Leiomyosarcoma of the larynx

Leiomyosarcoma (LMS) is an uncommon tumor among the spectrum of soft tissue sarcomas. It is exceedingly rare in the head and neck regions. We report a case of laryngeal LMS that presented with obstructive symptoms, which was amenable to conservative surgery and postoperative irradiation. There is no evidence of recurrent disease at 18-month follow-up.