Abstract
Background: Carcinosarcoma of hypopharynx is a rare neoplasm with both malignant epithelial and mesenchymal components. They are highly aggressive in nature with controversial histogenesis. To our knowledge, there is no case reported of carcinosarcoma of hypopharynx managed with wide LASER excision and modified radical neck dissection followed by chemoradiation. Method and Result: 42-year-old male presented complaints of foreign body sensation in throat, and difficulty in swallowing and hoarseness for 4 months. On examination, a large smooth globular mass filling the supraglottis obscuring the view of endolarynx was noted and right side level-II cervical lymphadenopathy was found. CECT neck revealed a large hypopharyngeal mass abutting the supraglottis. Microlaryngoscopic biopsy was reported as high grade carcinosarcoma and PET scan was done after 1 week which revealed no any distant metastasis. The patient was taken for transoral pulsed carbon dioxide LASER excision with modified radical neck dissection, and postoperative chemoradiation was done and after two years of closed follow-up MRI was done which revealed no disease and the patient is absolutely free of disease till now. Conclusion: It was a rare case which was managed with complete LASER excision with neck dissection and postoperative chemoradiation and the patient is absolutely free of disease till now after 2 years of follow-up.
Highlights
Carcinosarcoma is a rare neoplasm with both malignant epithelial and malignant mesenchymal components
True carcinosarcomas of the hypopharynx and larynx represent less than 1% of all malignant neoplasms in this area
The histogenesis is controversial and the most accepted theory is the differentiation of primitive blastic mesenchymal cells that can mature and produce malignant neoplasm of multiple differentiations [2]
Summary
Carcinosarcoma is a rare neoplasm with both malignant epithelial and malignant mesenchymal components. Carcinosarcoma of the head and neck is uncommon. Most reported cases have occurred in the major salivary glands; other sites include the larynx and pharynx and less frequently the oral and nasal cavities and the esophagus. True carcinosarcomas of the hypopharynx and larynx represent less than 1% of all malignant neoplasms in this area. The histogenesis is controversial and the most accepted theory is the differentiation of primitive blastic mesenchymal cells that can mature and produce malignant neoplasm of multiple differentiations [2]. There is no case reported on carcinosarcoma of hypopharynx managed with wide LASER excision and modified radical neck dissection followed
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