Laryngeal amyloidosis, report of a new case and review of the literature

Abstract

IntroductionAmyloidosis is related to the extracellular deposition in various tissues of an amorphous amyloid substance. Isolated laryngeal localization is very rare. ObservationWe report a case of localized laryngeal amyloidosis discovered during an isolated chronic dysphonia in a 45-year-old man, with no medical history, with no alcohol or tobacco intoxication. The histological and immunohistochemical study and further examinations confirmed the diagnosis of localized laryngeal amyloidosis without systemic location. The patient had a slight postoperative hoarseness that subsequently disappeared through speech therapy. DiscussionThe larynx remains a rare localization of amyloidosis. It is the most common form of amyloidosis of the upper aero digestive tract. Circumstances of discovery of laryngeal amyloidosis are dominated by hoarseness. Laryngoscopy may falsely suggest a neoplastic disease. Diagnosis is based upon histological examination with Congo red staining where amyloid deposits appear birefringent under polarized light. Surgery is the mainstay of treatment of symptomatic laryngeal amyloidosis. The survival of patients with laryngeal amyloidosis often exceeds ten years. ConclusionLaryngeal amyloidosis is essentially a local clinical form whose main symptom is dysphonia. The treatment is usually based on local endoscopic procedures but may require a laryngectomy in advanced forms, associated with colchicine. The prognosis is much better than systemic forms.