title: Atypical carcinoid tumour of the larynx treated with CO2 laser excision: case report.
abstract: A case of atypical laryngeal carcinoid tumour of the right aryepiglottic fold is described in a 56-year-old female. The patient presented a 4-year history of dysphagia, occasional dyspnoea and pain originating in the right tonsillar fossa and radiating to the ear. A sessile, submucosal neoplasm of about 1 cm in diameter and apparently benign appearance was detected endoscopically in the supraglottic region. An excisional biopsy was collected by CO2 laser during direct microlaryngoscopy from which a diagnosis of atypical carcinoid tumour of the larynx was made, and later confirmed by histochemical and immunohistochemical staining. Post-operative course was uneventful, with return to a normal diet per os on the first post-operative day. Histopathological evaluation of the excised specimen revealed the presence of a neoplasm in proximity of the surgical margins, which were not, however, directly involved by the tumour. The close endoscopic follow-up was, nonetheless, implemented in order to promptly detect any evidence of relapse of the disease. After 18 months, a lesion, suspected of being a recurrence, was found, in the site of the original tumour. CO2 laser excision was again carried out, this time allowing for wider margins on the surgical resection. The post-operative diagnosis confirmed the clinical hypothesis of recurrence of atypical carcinoid tumour. The patient is presently alive and free from disease 7 years after the second endoscopic procedure. The difficult aspects of clinical and histopathological diagnoses, the surgical treatment as well as endoscopic and instrumental follow-up of this rare condition are discussed.
authors.affiliation: Department of Otorhinolaryngology, University of Brescia, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Piazza
authors.forename: M
authors.initials: M
authors.lastname: Giudice
authors.forename: M
authors.initials: M
authors.lastname: Berlucchi
authors.forename: G
authors.initials: G
authors.lastname: Peretti
authors.forename: A R
authors.initials: AR
authors.lastname: Antonelli
mesh_terms: D002245:Carbon Dioxide / Q000627:therapeutic use*; D002276:Carcinoid Tumor / Q000601:surgery*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D008875:Middle Aged
chemical_list: D002245:Carbon Dioxide