A rare case of a laryngeal leiomyosarcoma with a lymph node metastasis

Highlights • Leiomyosarcoma of the larynx a very rare malignancy. • Leiomyosarcoma of the larynx may represent a serious diagnostic challenge. • No therapeutic protocol has been established yet. • Treatment modalities depends on size, location, extension of the tumor. • The prognosis is conditioned by the quality of surgical excision and the occurrence of recurrence and metastases.
Introduction Leiomyosarcoma is a rare mesenchymal tumor that originates from smooth muscle cells. Head and neck LMSs represent only 3% of all leiomyosarcomas with less than 50 cases of laryngeal LMS reported in the literature till now. Case presentation We report a case of 50-year-old male presented at our ENT department for a chronic hoarseness. Clinical examination investigations found small submucosal lesion in the right vocal cord. Treatment consisted of CO2 Laser excision of the lesion. The evolution was marked by the appearance of a tumefaction in the left submandibular region and a severe dyspnea requiring an emergency tracheotomy. Paraclinical examination investigations found a supraglottis–glottis-subglottis tumor. A total laryngectomy with bilateral functional neck dissection was performed and the histopathological examination found a laryngeal leiomyosarcoma. Conclusion LMS of the larynx a very rare malignancy. The accurate diagnosis is histological. Surgery is the mainstay of treatment. Its prognosis is correlated to local recurrence and distant metastases.