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Primary Sarcomas of the Larynx: A Clinicopathologic Study of 27 Cases

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Abstract

Primary sarcomas of the larynx are rare and are associated with diagnostic and treatment challenges. Studies of these tumors are limited, and most examples have been reported as small series. To further increase our understanding of laryngeal sarcomas, we reviewed our experience of an adult cohort. A retrospective search for laryngeal sarcomas from our pathology archives and consultation files of one of the authors was performed. We studied 27 primary laryngeal sarcomas that included 25 males, and 2 females, with a mean age of 60 years (range 33–85). The cases included conventional chondrosarcoma (16), well-differentiated liposarcoma (2), clear cell chondrosarcoma (1), leiomyosarcoma (2), high grade myxofibrosarcoma (2), high grade myofibroblastic sarcoma (1), low-grade myofibroblastic sarcoma (1), malignant granular cell tumor (1), and Kaposi sarcoma (1). Data on treatment and follow-up was available in 17 and 16 cases, respectively. 12 patients underwent partial laryngeal resection; five had total laryngectomy, and the patient with Kaposi sarcoma received combined highly active antiretroviral therapy and chemotherapy. Three patients developed local recurrence, and two patients developed metastases. The remaining patients with follow up had a favorable outcome and were disease-free after treatment. The important differential diagnosis of spindle cell sarcoma is sarcomatoid squamous cell carcinoma, and their distinction often requires extensive sampling of the mucosal surface and immunohistochemical analysis. The mainstay of treatment for laryngeal sarcomas is surgical removal, with the extent dictated by tumor type and grade. Adjuvant therapy is reserved for high-grade sarcomas and may be given in a neoadjuvant or adjuvant setting.

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Authors and Affiliations

  1. Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, 1400 NW 12th Avenue, Room 4078, Miami, FL, 33136, USA

    Jaylou M. Velez Torres, Julio A. Diaz-Perez, Carmen Gomez-Fernandez & Andrew E. Rosenberg

  2. Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA

    Ernesto Martinez Duarte

  3. Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA

    Jason Leibowitz, Donald T. Weed, Giovanna Thomas, Francisco J. Civantos & David J. Arnold

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  1. Jaylou M. Velez Torres
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  2. Ernesto Martinez Duarte
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Contributions

JVT, AER, JADP, and EMD contributed to the study conception and design. Material preparation, data collection, and analysis were performed by JVT, EMD, JL, DW, GT, FC, DA, CGF, and JADP. JVT and AER wrote and edited the manuscript. JVT and AER provided radiographs and micrographs. All authors read and approved the final manuscript.

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Correspondence to Jaylou M. Velez Torres.

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Velez Torres, J.M., Martinez Duarte, E., Diaz-Perez, J.A. et al. Primary Sarcomas of the Larynx: A Clinicopathologic Study of 27 Cases. Head and Neck Pathol 15, 905–916 (2021). https://doi.org/10.1007/s12105-021-01314-8

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