Case report: Adenocarcinoma of the larynx with later hepatocellular differentiation

Abstract

Head and neck cancer accounts for 3.5% of annual worldwide cancer diagnoses with the larynx being part of it. The main methods of treatment include laryngectomy, but mainly a combination of radiation with chemotherapy and then combinations of chemotherapy with immunotherapy in more advanced stages of the disease. Histologically it is mostly squamous cell carcinoma, but cases of glandular differentiation have been reported that favor the entry of these patients into clinical trials. In our case we discuss a patient diagnosed with adenocarcinoma to the larynx area treated initially with laryngectomy and radiotherapy. In metastatic setting, he received multiple treatment lines with chemotherapy and immunotherapy and a later biopsy from a paraspinal mass which pathology resulted in an adenocarcinoma from the larynx, with hepatocellular differentiation. We performed upper endoscopy which revealed a high-grade dysplasia and the initiation of irinotecan led to a rapid clinical deterioration.