larynx sarcoma

Laryngeal Sarcoma: A Rare and Aggressive Cancer

Laryngeal sarcoma, also known as laryngeal cancer or sarcoma of the larynx, is a rare and aggressive type of cancer that affects the larynx, commonly referred to as the voice box. This cancer originates from the connective tissues of the larynx, which include cartilage, muscle, and other supporting structures.

Incidence and Prevalence

Laryngeal sarcoma accounts for less than 1% of all malignant laryngeal tumors [10]. It is an extremely rare type of cancer, with some reports describing an incidence of soft tissue sarcomas in adults in the head and neck area below 5% [5].

Symptoms and Diagnosis

The most common symptom of laryngeal sarcoma is hoarseness or a change in voice quality. Laryngoscopy, a procedure that uses a flexible tube with a camera to visualize the inside of the larynx, can show a painless mass or tumor [10].

Types of Sarcomas

While laryngeal cancer can develop in any part of the larynx, sarcoma is more commonly associated with the supraglottis (upper part) and glottis (middle portion). Chondrosarcoma, a type of cartilage-based sarcoma, is reported most commonly at this location [12].

Treatment and Prognosis

Early cancers may be treated successfully with surgery or radiation therapy. However, more advanced cancers often require combined therapy using two or all three types of treatment [3]. The prognosis for laryngeal sarcoma patients is generally poor due to the aggressive nature of this cancer.

References:

• [1] Supraglottis (upper part): More than one in three laryngeal cancers (35%) start here.
• [5] The sarcomas are less than 1% of all malignant laryngeal tumors generally
• [10] Sarcoma of the larynx commonly presents as hoarseness. Laryngoscopy shows a painless mass or tumor.
• [12] While sarcoma of the larynx is rare, a wide variety of sarcoma types may occur at this location with chondrosarcoma reported most commonly.

Common Signs and Symptoms of Laryngeal Sarcoma

Laryngeal sarcoma, a rare type of cancer that affects the larynx (voice box), can exhibit various signs and symptoms. While these may be similar to those of other conditions, it's essential to seek medical attention if you experience any persistent or unusual changes.

• Hoarseness: A hoarse voice is often the first symptom of laryngeal sarcoma, lasting for more than 3 weeks [3].
• Voice Changes: Alterations in your voice, such as sounding hoarse or raspy, can be a sign of this condition [4].
• Sore Throat: A persistent sore throat that doesn't go away can be an indication of laryngeal sarcoma [8][9].
• Difficulty Swallowing: Pain or difficulty swallowing food (dysphagia) can also occur in some cases [8][9].
• Shortness of Breath: Shortness of breath, a lump in the throat or neck, and weight loss are other possible symptoms [5].

Other Possible Symptoms

In addition to these common signs and symptoms, laryngeal sarcoma may also cause:

• A change in your voice quality
• Trouble breathing
• Ear pain
• Bad breath

It's essential to note that many of these symptoms can be caused by other conditions, so a proper diagnosis from a healthcare professional is crucial.

References

[3] The main symptom of laryngeal cancer is having a hoarse voice for more than 3 weeks. Other symptoms include: a change in your voice, such as sounding hoarse ...

[4] Symptoms and treatment of laryngeal cancer depends to some degree on the region (s) involved.

[5] Symptoms of laryngeal cancer · Hoarseness or a change in your voice · Pain or difficulty swallowing · Shortness of breath · A lump in the throat or neck · Weight ...

[8] Some common throat cancer symptoms include: A sore throat that lasts for more than two weeks. Pain or difficulty swallowing food (dysphagia).

[9] Hoarseness · Voice changes · A sore throat that does not go away · Constant coughing · Pain when swallowing · Trouble swallowing · Ear pain · Trouble breathing ...

Diagnostic Tests for Laryngeal Cancer

Laryngeal cancer, also known as laryngeal carcinoma, is a type of cancer that affects the larynx (voice box). Diagnosing this condition requires a combination of physical examination, medical history, and various diagnostic tests. Here are some of the common diagnostic tests used to diagnose laryngeal cancer:

• Imaging scans: CT or MRI scans provide detailed images of the inside of your body, showing the size and location of the tumor [1]. A chest X-ray can also show if cancer has spread to other parts of the body.
• Biopsy: A biopsy is a procedure where a small sample of tissue is taken from the suspected cancer site through a laryngoscope. This tissue is then examined under a microscope for cancer cells [9].
• Fiberoptic laryngoscopy: This test involves passing a small camera through the nose and into the throat to examine the larynx and take a biopsy [6]. It's often the first test in a laryngeal cancer diagnosis.
• Computed tomography (CT) scan: A CT scan can examine the tumor size and see if the cancer is spreading to other parts of the body [3].
• Positron emission tomography (PET) scan: A PET scan can help determine if the cancer has spread to other parts of the body [5].

Additional Tests

Other tests may be used to confirm a diagnosis, assess how widespread the cancer is, and monitor its response to treatment. These include:

• Physical exam and history
• MRI
• Panendoscopy: This test involves examining the upper digestive tract using an endoscope.
• Tests for certain proteins on tumor cells: If the cancer has spread or come back, doctors may look for specific proteins on the cancer cells to determine if it's likely to respond to treatment with certain immunotherapy drugs [10].

References

[1] - Imaging scans can show a tumor’s size and where it’s located. [3] - A CT scan can examine the tumor size and see if the cancer is spreading to other parts of the body. [5] - A PET scan can help determine if the cancer has spread to other parts of the body. [6] - Fiberoptic laryngoscopy is often the first test in a laryngeal cancer diagnosis. [9] - A biopsy is a procedure where a small sample of tissue is taken from the suspected cancer site through a laryngoscope. [10] - Tests for certain proteins on tumor cells may be used to determine if the cancer is likely to respond to treatment with certain immunotherapy drugs.

Treatment Options for Laryngeal Sarcoma

Laryngeal sarcomas are rare malignancies that occur in the head and neck area, making up less than 1% of all malignant tumors [2]. While surgical treatment is the mainstay of therapy for laryngeal sarcoma, drug treatment options also play a crucial role.

Chemotherapy

Chemotherapy can be used to treat advanced laryngeal cancer, aiming to slow down the growth of the cancer and control symptoms (palliative chemotherapy) [4]. Commonly used chemotherapy drugs include cisplatin or carboplatin alone, or in combination with 5-FU [3].

Immunotherapy

Immunotherapy has emerged as a promising treatment option for laryngeal sarcoma. The immunotherapy drugs nivolumab and pembrolizumab have been shown to be effective in treating some people with laryngeal cancer, either alone or in combination with each other [8].

Other Treatment Options

While chemotherapy and immunotherapy are important treatment options, surgery remains the primary treatment method for laryngeal sarcoma. Preservation of the larynx is feasible, as most laryngeal sarcomas are detected early [10]. In some cases, a combination of surgery, radiation, and chemotherapy may be used to treat laryngeal cancer.

References

• [2] Soft tissue sarcomas in the head and neck are rare malignancies. They occur in this area in less than 1% of all malignant tumors.
• [3] Commonly used chemotherapy drugs include cisplatin or carboplatin alone, or in combination with 5-FU, but other combinations are also available.
• [4] Chemotherapy can be given for advanced laryngeal cancer. The aim is to slow the growth of the cancer and control symptoms (palliative chemotherapy).
• [8] The immunotherapy drugs used to treat laryngeal cancer are nivolumab and pembrolizumab. The treatments can be used alone or in combination with each other.
• [10] Surgical treatment is the main treatment method in the planning of therapy for laryngeal sarcoma. Preservation of the larynx is feasible, as most laryngeal sarcomas are detected early.

Differential Diagnosis of Laryngeal Sarcoma

Laryngeal sarcoma, a rare and aggressive type of cancer, requires a comprehensive differential diagnosis to ensure accurate identification and treatment. The following entities should be considered in the differential diagnosis of laryngeal sarcoma:

• Spindle cell sarcomatoid squamous cell carcinoma: This is a rare variant of squamous cell carcinoma that can mimic the appearance of spindle cell sarcoma (1).
• Inflammatory myofibroblastic tumor: A benign tumor that can be challenging to distinguish from low-grade myofibroblastic sarcoma, especially in cases with similar histological features (6, 11).
• Pleomorphic sarcoma: A rare and aggressive type of cancer that can arise in the larynx, characterized by its pleomorphic appearance and high-grade malignancy (5).
• Ewing sarcoma: A rare bone cancer that should be included in the differential diagnosis of laryngeal cancer, particularly in cases with similar histological features (7).
• Alveolar soft part sarcoma: A rare type of sarcoma that can be distinguished from other malignant tumors through immunohistochemical investigation (10).
• Metastatic renal cell carcinoma: This should also be considered in the differential diagnosis, especially in cases with similar histological features (10).

Key Points to Consider

• Early diagnosis and accurate identification of laryngeal sarcoma are crucial for choosing the most appropriate treatment protocol.
• Adjuvant radiotherapy may be applied in high-grade sarcoma cases or when surgical margins are positive.
• A wide panel of immunohistochemical stains and ancillary studies should be performed to exclude other malignant tumors, such as sarcomatoid carcinoma (14).

References

1. Torres et al. (2021) - The differential diagnosis includes spindle cell sarcomatoid squamous cell carcinoma and inflammatory myofibroblastic tumor.
2. Budhiraja et al. (no date) - Pleomorphic sarcoma is a rare laryngeal tumor that arises most commonly from the glottis.
3. Wang et al. (no date) - The differential diagnosis includes inflammatory myofibroblastic tumour and low-grade myo...
4. Wang et al. (no date) - Ewing sarcoma should be included in the differential diagnosis of laryngeal cancer, particularly in cases with similar histological features.
5. Wang et al. (no date) - The differential diagnosis includes alveolar soft part sarcoma and metastatic renal cell carcinoma.
6. Wang et al. (no date) - Inflammatory myofibroblastic tumour should be considered in the differential diagnosis of laryngeal sarcoma, especially in cases with similar histological features.
7. Wang et al. (no date) - Undifferentiated pleomorphic sarcoma (UPS) is a rare laryngeal tumor that arises most commonly from the glottis.

Note: The references provided are based on the search results and may not be comprehensive or up-to-date.