Low Grade Laryngeal Chondrosarcoma of the Cricoid Cartilage: A Case Report.

INTRODUCTION

Laryngeal chondrosarcomas are an extremely rare class of tumor accounting for only 1% of all laryngeal tumors. The cricoid cartilage is the most common cartilage from which laryngeal chondrosarcomas arise however, it is also the most difficult to treat as the cricoid cartilage is vital for structural support in the larynx. In this study, we describe a case of low-grade laryngeal chondrosarcoma that arose in the cricoid cartilage and was treated with laser resection while retaining full function of the larynx.

CASE REPORT: The patient was a 61-year-old man who presented with a two-year history of hoarseness and recent intermittent swelling of the neck. After initial exam, a CT scan was ordered and showed a 2.7 cm calcified mass in the patient's larynx. Subsequent bronchoscopy found a dome shaped mass of the cricoid cartilage resulting in a 50% airway reduction. A biopsy was taken and diagnosed as low-grade laryngeal chondrosarcoma. Laser resection by way of anterior commissure laryngoscope was determined to be the best treatment course as it would result in the best chance of functional retention. Using this method, the mass was debulked to the point that a ridged Hopkins rod telescope could be passed through the airway although complete resection was not possible. The patient reported significant improvement to his symptoms. This improvement was sustained 5 months post- operatively and the mass showed no signs of progression to that point.

CONCLUSIONS

This case presented a rare tumor in a location where functional retention is difficult. Through laser resection, the tumor was removed with complete functional retention and abolition of symptoms. Though recurrence is an ever-present possibility, the low grade of the tumor combined with the slow progression of symptoms pre-operatively suggests this surgery could provide extended relief of symptoms.