Abstract
Supraglottic adenoid cystic carcinoma (ACC) is extremely rare and may be misdiagnosed as laryngeal amyloidosis. The present report describes a case of supraglottic ACC, which went unrecognized until histopathological examination of the neoplasm 18 months after the first presentation. The present patient presented with progressive hoarseness for half a year and initially required partial resection. Following quick regional recurrence, the patient received a total laryngectomy while refusing radiotherapy. Adjuvant post-operational traditional Chinese medicine was accepted. Over 3 years’ follow-up, there was no evidence of regional relapse or distant metastases. The present case is compared with a second case of supraglottic submucosal mass in which the signs, symptoms and examinations were similar to the first case, but that was diagnosed as laryngeal amyloidosis. Attention should be paid to submucosal masses in the larynx to prevent underlying malignancy and subsequent disease progression. Immunocytochemistry, such as p63 staining, is mandatory for making an early differential diagnosis of supraglottic ACC. Traditional Chinese medicine may be a useful adjuvant therapy for this rare disease.
Highlights
Adenoid cystic carcinoma (ACC) of the larynx is an extremely rare disease that arises from the laryngeal glandular elements [1]
The objective of this study is to show that the duration and progression of laryngeal ACCs may be quite variable, occasionally appearing as benign as amyloidosis, and the predilection for unnoticeable spreading may account for the locally advanced tumors and would account for the high incidence of positive or even ‘negative’ margins on surgical specimens
As accessory salivary glands are exiguous in the larynx, laryngeal ACC is a rare disease, accounting for
Summary
Adenoid cystic carcinoma (ACC) of the larynx is an extremely rare disease that arises from the laryngeal glandular elements [1]. The clinical characteristics of supraglottic ACC can be confused with those of laryngeal amyloidosis, which is a rare benign tumor. Fiberoptic laryngoscopy revealed swelling of the left ventricular fold and laryngeal ventricle that extended backwards to the left aryepiglottic fold. The laryngeal abnormal sensation gradually progressed, and after 18 months the patient underwent a second laryngoscopy, which revealed similar findings to the first without obvious progression (Fig. 1B). As the patient refused to undergo an expanded total laryngectomy, which is indicated for a locally advanced laryngeal tumor [3], local resection of the left ventricular fold, laryngeal ventricle and aryepiglottic fold was performed only (Fig. 2A). There was no sign of lymphatic spreading, QIAN et al: SUPRAGLOTTIC ACC MIMICKS LARYNGEAL AMYLOIDOSIS. During the 42‐month follow‐up period, there was no evidence of regional relapse or distant metastases
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