Function Sparing Conservative Approach of a Low-Grade Chondrosarcoma of the Larynx: Case Report and Literature Review

Abstract

Background: Laryngeal cancer is relatively uncommon in Ecuador. Usually epithelial in origin, the most frequent histological type is squamous cell carcinoma. The most common mesenchymal tumor is chondrosarcoma. Most laryngeal chondrosarcomas are treated with total laryngectomy, but a conservative function sparing resection is recommended in low-grade limited tumors. Case Report: In a 68-year-old female nonsmoker patient, a small tumor was found in the posterior left aspect of the cricoid cartilage in a computed tomography (CT) performed immediately after an unexpected difficulty to pass the endotracheal tube for a thoracoscopic biopsy of 4 cm tumor of the left lung, in another hospital. The patient underwent, then, an initial tracheostomy, a total thyroidectomy for a goiter and a biopsy of the tumor of the cricoid cartilage whose pathological study was inconclusive. One month later, a low-grade neuroendocrine pulmonary tumor was completed resected. Two years later, a CT scan showed the cricoid lesion with the same characteristics. At endoscopic video laryngoscopy, two subglottic masses that narrowed the airway in approximately 60% of the normal caliber, were observed located at the posterior and left walls. An intraluminal resection was performed through a transcricoid anterior approach. The pathological diagnosis was a low-grade chondrosarcoma. Tracheal decannulation was performed one month later. At an endoscopic video laryngoscopy performed six months post-operatively, the tracheal caliber and mucosa were normal. The patient remained with normal voice and breathing. Conclusion: We report the second case of chondrosarcoma of the larynx in our country, treated by a conservative approach.