Auris Nasus Larynx. 2012 Feb 14;
Harirchian S, Mirani NM, Baredes S

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 46year 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.

Kulak Burun Bogaz Ihtis Derg. 2012 Jan-Feb; 22(1): 50-3
Acar GO, Tekin M, Cam OH

Inflammatory myofibroblastic pseudotumor (IMP) is a rare neoplasm usually found in the lower respiratory tract, pulmonary system, and abdominal cavity. Conservative surgical procedures are often performed in the management of the tumor. In this article, we present a 64-year-old male with a local IMP of the larynx. The clinical presentation, diagnosis, histopathology, and management of this uncommon tumor were also discussed.

J Craniofac Surg. 2012 Jan; 23(1): e1-2
Yilmaz M, Ibrahimov M, Mamanov M, Rasidov R, Oktem F

ABSTRACT: Extranodal non-Hodgkin lymphomas limited to the larynx are rare, accounting for less than 1% of all laryngeal neoplasms. The most common site of development of primary laryngeal lymphomas is the supraglottic region. In most cases, the presenting symptoms are hoarseness, dysphagia, dyspnea, and cervical lymphadenopathy. In these cases, larynx lymphoma was the mucosa-associated lymphoid tissue type and located in the supraglottic area.

Eur Arch Otorhinolaryngol. 2012 Feb 5;
Hassumi-Fukasawa MK, Miranda-Camargo FA, Guimarães MC, Simões RT, Donadi EA, Soares CP, Soares EG

Laryngeal squamous cell carcinoma is one of the most common malignant neoplasms of the head and neck. In Brazil, laryngeal tumors represent 2% of all cancers and are associated with approximately 3,000 deaths annually. Human papillomavirus (HPV) has been reported to play an important role in the etiology of laryngeal cancer. The aim of the present study was to evaluate the expression of p53, p27, and Mdm2 in laryngeal carcinomas. Sixty-three larynx biopsies were selected for the study, including 9 in situ laryngeal carcinomas, 27 laryngeal carcinomas without metastasis and 27 laryngeal carcinomas with metastasis. Twenty-seven cervical lymph nodes from patients with metastatic lesions were also evaluated. The expression levels of p53, p27, and Mdm2 were assessed by immunohistochemistry using a computer-assisted system. HPV detection and typing were performed using PCR, and the HPV types that were evaluated included HPV 6, 11, 16, 18, 31 and 33. Out of 63 patients, 53 (84.1%) were positive for β-globin (internal control), and 10 (15.9%) were β-globin negative and therefore excluded from the evaluation. Thus, 7 (13.2%) out of 53 patients were HPV positive, and 46 (86.8%) out of 53 patients were HPV negative. Statistically significant differences (p < 0.05) in Mdm2 expression levels were observed in the in situ laryngeal carcinoma samples compared with the laryngeal carcinoma samples with metastasis. No statistically significant differences (p > 0.05) in either p53 or p27 expression levels were detected. These findings suggest that Mdm2 may be associated with the invasiveness and aggressiveness of laryngeal carcinomas.

Head Neck. 2012 Feb 6;
Angouridakis N, Goudakos J, Karayannopoulou G, Triaridis S, Nikolaou A, Markou K

BACKGROUND: Neuroendocrine tumors are rare neoplasms arising from neural and epithelial origin. METHODS AND RESULTS: The case records of 4 patients with the diagnosis of neuroendocrine laryngeal tumor were retrospectively reviewed. In this analysis of our medical records, we describe a series of 4 men with neuroendocrine laryngeal tumors treated in our department since 1994, including the first extremely aggressive and lethal laryngeal paraganglioma reported in the English-language literature. We also discuss the classification, the macro and microscopical characteristics, clinical and pathologic findings, and treatment of these neoplasms. CONCLUSION: Although neuroendocrine laryngeal tumors account for approximately 1% of all neoplasms in the larynx, its majority represents very aggressive tumors showing a capacity for metastasis and portending poor outcome. © 2012 Wiley Periodicals, Inc. Head Neck, 2012.

Ann Otol Rhinol Laryngol. 2011 Dec; 120(12): 820-7
Shen B, Li D, Dong P, Gao S

Two prominent and well-characterized representatives of adenosine triphosphate-binding cassette (ABC) transporter - breast cancer resistance protein (BCRP or ABCG2) and P-glycoprotein (P-gp or ABCB1) - are known to be membrane transporters associated with multidrug resistance. The aim of this study was to explore the correlation between ABC transporter expression and the clinicopathologic characteristics, proliferative index, and apoptotic index and their prognostic value in laryngeal squamous cell carcinoma (LSCC).Paraffin sections of 98 human LSCC specimens were investigated with immunohistochemical techniques. The relationship between ABCG2 and ABCB1 expression and clinicopathologic parameters, proliferative activities, and apoptotic activities and their prognostic value in patients' overall survival rate were subsequently analyzed.Immunohistochemical analysis revealed positive expression of ABCG2 and ABCB1 in 52.0% and 41.8% of patients, respectively. There was a positive correlation between ABCG2 expression and ABCB1 expression. The presence of these two proteins was significantly related to clinical stage, lymph node metastasis, and overall survival in LSCC. Interestingly, up-regulation of ABCG2 expression was found to be associated with increased proliferation, but that of ABCB1 was not. Up-regulation of both ABCG2 expression and ABCB1 expression was associated with decreased apoptosis.The results of this study revealed that the presence of ABCG2 and/or ABCB1 is predictive for malignant progression and is an independent prognostic factor in LSCC. The mechanism of ABC transporters may contribute to chemotherapy resistance by promoting proliferation and/or suppressing apoptosis.

Nihon Jibiinkoka Gakkai Kaiho. 2011 Nov; 114(11): 855-63
Kikuchi M, Shinohara S, Fujiwara K, Yamazaki H, Kanazawa Y, Kurihara R, Kishimoto I, Harada H, Naito Y

We analyzed open biopsy in diagnosing primary thyroid lymphoma (PTL) and tumor management with compression symptoms and therapy.We retrospectively studied 24 subjects diagnosed with PTL from December 1997 to June 2010.Open biopsy was done in 23 of 24 subjects. Incisional biopsy was done in 14, 13 of whom yielded sufficient materials in the first biopsy. Excisional biopsy was done in the remaining 9, 2 of whom developed permanent recurrent laryngeal nerve palsy after biopsy. The five with airway obstruction underwent incisional biopsy followed by immediate steroid administration of dexamethasone or methylprednisolone. All had histopathologically confirmed diagnosis and airway symptoms were resolved within a few days. Multidisciplinary therapy including chemotherapy, radiotherapy, and surgery was applied in 20 of 24 subjects. Single therapy was done in 4-chemotherapy in 2 and radiotherapy and surgery in 1 each. Overall results were satisfactory, with a 92% 10-year disease-free survival rate and an 86% 10-year overall survival rate based on the Kaplan-Meier method with 46-month median follow up.When diagnosing PTL, especially large tumors spreading into extrathyroid tissue, incisional biopsy is more advantageous in histopathological diagnosis than excisional biopsy due to the lower risk of surgical complications. In a case involving a small intrathyroidal nodule, excisional biopsy is safer and more diagnostically accurate. In an airway obstruction emergency, once a definitive diagnosis is made, steroid administration plus endotracheal intubation, if necessary, for airway management is optimal management. Subjects with stage IE mucosa-associated lymphoid tissue (MALT) lymphomas can be treated with radiotherapy or surgery alone. Those with diffuse large B-cell lymphoma (DLBCL) or greater than stage IE MALT lymphoma, however, should be treated with multidisciplinary therapy because they have a potentially poor outcome.

Ann Otol Rhinol Laryngol. 2011 Nov; 120(11): 748-54
Berg EE, Kolachala V, Branski RC, Muller S, Johns MM

We sought to better characterize pathologic changes that occur in the human vocal fold after radiotherapy for head and neck cancer.In a blinded, controlled study of archived tissue, we evaluated postirradiation salvage laryngectomy vocal fold tissue without evidence of malignant disease. Clinical and demographic patient data were collected. In a blinded fashion, irradiated tissue was compared to nonirradiated, benign control tissue. Histomorphometric analysis was used to assess muscle and collagen organization, superficial lamina propria (SLP) and vocal ligament thickness, vocalis muscle fiber area, collagen content, and hyaluronic acid content. Immunohistochemical analysis was used to assess the content of type I collagen, type IV collagen, vimentin, fibronectin, alpha-smooth muscle actin, matrix metalloproteinase 9, and laminin.Twenty irradiated vocal folds were evaluated and compared to control specimens. Collagen and muscle disorganization was noted in the irradiated specimens. The SLP and vocal ligament thicknesses and the mean muscle fiber diameters did not differ significantly. The SLP fibronectin and the vocalis muscle and SLP collagen content were significantly increased in the irradiated vocal folds, and the SLP collagen content increased significantly with time between irradiation and resection. The laminin content of irradiated vocalis muscles was significantly decreased.Radiotherapy results in significant vocal fold tissue changes. Having more precisely defined these changes, we plan continued investigation seeking targeted preventive and therapeutic interventions for improved vocal quality following radiotherapy.

Acta Microbiol Immunol Hung. 2011 Dec; 58(4): 319-37
Fehér E, Kardos G, Gáll T, Kis A, Gergely L, Szarka K

Diversity of TTV1 was assessed in the head and neck region in patients with potentially malignant (oral lichen planus, oral leukoplakia) and malignant lesions (oral and laryngeal squamous cell cancers) and was compared to that found in the uterine cervix (cervical atypia and cervical cancer) by directly sequencing the NG061-063 segment of ORF1. These sequences were classified by the formerly used genogroup-genotype system as well as by the newly accepted species classification by aligning with the corresponding region of the type sequences of the 29 TTV species. All sequences obtained during the study clustered together with the TTV1 type sequence; to express diversity within TTV1, genotypes and subtypes of the former classification were used.The commonest subtypes were 2c followed by 2b, 1a and 1b. Subtypes 2b and 2c were evenly distributed among cervical samples; subtype 1a was more frequent in patients with cervical atypia or cancer. Subtypes 2c was more frequent than 2b in head and neck lesions. In conclusion, genotype and even subtype distribution may be important in association with diseases, therefore using this classification for characterization of intraspecies diversity of TTV1 is proposed.

J Pak Med Assoc. 2011 Jun; 61(6): 607-10
Arain A, Ghaffar S

A retrospective analysis was performed on patients subjected to near-total laryngectomy at Aga Khan University Hospital Karachi from September 2006 and May 2010, to evaluate the functional outcome of Near Total Laryngectomy and its effect on disease control. In all of these advanced stage laryngeal-hypopharyngeal squamous cancer patients, the disease was limited to one side of the larynx-hypopharynx. Four patients were staged as T3 and rest were T4; near total laryngectomy was done in all 07 patients. Post operative adjuvant radiotherapy was given to 06 patients. All of these patients are on regular oral diet and maintaining their body weight. Six patients are using their preserved hemi larynx effectively. Mean follow up of these patients was 15 months. Three patients developed regional recurrence whereas the remaining four patients were well till their last follow-up. Near total laryngectomy is a safe surgical option even for advanced laryngeal-hypopharyngeal cancer without compromising oncological clearance. It gives patients their own physiological voice that does not require maintenance but at the expense of permanent tracheostomy.

Acta Otorrinolaringol Esp. 2011 Dec 22;
López-Álvarez F, Gómez-Martínez JR, Suárez-Nieto C, Llorente-Pendás JL

Schwannomas are benign tumours, rare among tumours of the larynx. They normally present as supraglottic masses (because they may arise from the internal branch of the superior laryngeal nerve), most commonly involving aryepiglottic folds or false vocal folds. Most patients present with a globus sensation, dysphagia or hoarseness. Conservative surgery is the treatment of choice. We report a case of a laryngeal asymptomatic neuroma that was diagnosed accidentally in an imaging test. Complete excision of the tumour was performed through a transoral CO(2) laser microsurgery without resorting to a tracheotomy. We discuss the clinical, pathologic and imaging findings and the management of this neoplasm. We also try to update the knowledge on the management of these tumours.

Kyobu Geka. 2011 Nov; 64(12): 1119-21
Fujiwara T, Shimoda A, Nishikawa T, Kataoka K, Matsuura M

A 77-year-old woman who had been treated for tongue cancer, esophageal cancer and laryngeal cancer, 25 years, 8 years and 8 months before respectively, was referred to our department because of the pulmonary tumor. Enhanced computed tomography showed a nodule of 32 mm in diameter in the left upper lobe and persistent left superior vena cava (PL-SVC). She underwent left upper lobectomy with mediastinal lymph node dissection, preserving PL-SVC. PL-SVC is a rare anomaly and may disturb the mediastinal lymph node dissection. Care should always be taken for the possibility of anomalous venous connection in performing thoracic surgery.