Laryngeal Chondrosarcoma of the Arytenoid Cartilage Presenting as Bilateral Vocal Fold Immobility: A Case Report and Literature Review

  • Rong Hu
    Affiliations
    Department of Otorhinolaryngology—Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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  • Wen Xu
    Correspondence
    Address correspondence and reprint requests to Wen Xu, Department of Otorhinolaryngology—Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, 1 Dongjiaominxiang, Beijing 100730, China.
    Affiliations
    Department of Otorhinolaryngology—Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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  • Honggang Liu
    Affiliations
    Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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  • Xuejun Chen
    Affiliations
    Department of Otorhinolaryngology—Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Published:October 04, 2013DOI:https://doi.org/10.1016/j.jvoice.2013.06.002

      Summary

      Objectives

      To describe an atypical case of laryngeal chondrosarcoma of arytenoid cartilage presenting as bilateral vocal fold immobility and to avoid potential missed diagnosis.

      Methods

      Our case study included a detail history, physical and radiological examination, laryngeal electromyography (LEMG), and surgical treatment and pathology analysis. We compared it with the previously discussed cases of chondrosarcoma of arytenoid cartilage in the literature.

      Results

      Chondrosarcomas of the arytenoid cartilage is rare, and to date only approximately 10 cases have been reported. We reported a case of a 51-year-old man with 1 month of persistent dyspnea presenting with bilateral vocal fold immobility without neoplasms in larynx. The LEMG showed no obvious abnormality. The cervical-enhanced computed tomography (CT) found no significant signs of a mass except for localized high-density areas in arytenoid cartilage. Right arytenoidectomy and biopsy were performed under general anesthesia with CO2 laser with the pathological diagnosis of chondroma. A total laryngectomy was performed 2 years later, and low-grade chondrosarcoma was the final diagnosis.

      Conclusions

      Laryngeal chondrosarcomas of the arytenoid cartilage are rare. It is easily neglected, especially in those cases presenting with idiopathic vocal fold immobility without any obvious signs of neoplasms. The LEMG and laryngeal CT are necessary. Sometimes, a biopsy of the arytenoid cartilage is essential.

      Key words

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      References

        • Burkey B.B.
        • Hofman H.T.
        • Baker S.R.
        • Thornton A.F.
        • McClatchey K.D.
        Chondrosarcoma of the head and neck.
        Laryngoscope. 1990; 100: 1301-1305
        • Franco Jr., R.A.
        • Singh B.
        • Har-El G.
        Laryngeal chondroma.
        J Voice. 2002; 16: 92-95
        • Nao E.E.
        • Bozec A.
        • Vallicioni J.
        • et al.
        Laryngeal chondrosarcoma: report of two cases.
        Eur Ann Otorhinolaryngol Head Neck Dis. 2011; 128: 191-193
        • Mokhtari S.
        • Mirafsharieh A.
        Clear cell chondrosarcoma of the head and neck.
        Head Neck Oncol. 2012; 20: 13
        • Huizenga C.
        • Balogh K.
        Cartilaginous tumors of the larynx. A clinicopathologic study of 10 new cases and a review of the literature.
        Cancer. 1970; 26: 201-210
        • Finn D.G.
        • Goepfert H.
        • Batsakis J.G.
        Chondrosarcoma of the head and neck.
        Laryngoscope. 1984; 94: 1539-1544
        • Moran C.A.
        • Suster S.
        • Carter D.
        Laryngeal chondrosarcomas.
        Arch Pathol Lab Med. 1993; 117: 914-917
        • Lippert B.M.
        • Claassen H.
        • Bäumken J.
        • Jänig U.
        • Werner J.A.
        Laryngorhinootologie. 1997; 76 ([Article in German]): 28-35
        • Rinaldo A.
        • Howard D.J.
        • Ferlito A.
        Laryngeal chondrosarcoma: a 24-year experience at the Royal National Throat, Nose and Ear Hospital.
        Acta Otolaryngol. 2000; 120: 680-688
        • Shinhar S.
        • Zik D.
        • Issakov J.
        • Rappaport Y.
        Chondrosarcoma of the larynx—a therapeutic challenge.
        Ear Nose Throat J. 2001; 80 (572, 574): 568-570
        • Lee S.
        • Sparano A.
        • Zhang P.
        • Mirza N.
        Chondrosarcoma of the arytenoid cartilage: a case report and review of the literature.
        Ear Nose Throat J. 2007; 86: 759-762
        • Kanotra S.P.
        • Kanotra S.
        • Paul J.
        • Jamwal P.S.
        Chondrosarcoma of the arytenoids cartilage.
        Ear Nose Throat J. 2010; 89: E6-E10
        • New G.B.
        Sarcoma of the larynx: report of two cases.
        Arch Otolaryngol. 1935; 21: 648-652
        • Oneal L.W.
        • Ackerman L.V.
        Chondrsarcoma of bone.
        Cancer. 1952; 5: 561-567
        • Rozeman L.B.
        • Hogendoorn P.C.
        • Bovee J.V.
        Diagnosis and prognosis of chondrosarcoma of bone.
        Expert Rev Mol Diagn. 2002; 2: 461-472
        • Czecior E.
        • Scierski W.
        • Misiołek M.
        • Sowa P.
        • Namyslowski G.
        Reconstruction of the larynx after a resection of a huge chondrosarcoma.
        Otolaryngol Pol. 2011; 65: 459-461
        • Zeitels S.M.
        • Burns J.A.
        • Wain J.C.
        • Wright C.D.
        • Rosenberg A.E.
        Function preservation surgery in patients with chondrosarcoma of the cricoid cartilage.
        Ann Otol Rhinol Laryngol. 2011; 120: 603-607
        • de Vincentiis M.
        • Greco A.
        • Fusconi M.
        • Pagliuca G.
        • Martellucci S.
        • Gallo A.
        Total cricoidectomy in the treatment of laryngeal chondrosarcomas.
        Laryngoscope. 2011; 121: 2375-2380