Laryngeal carcinoma presenting as a large anterior neck abscess.
Laryngeal carcinoma presenting as a cervical abscess is rare, so that its diagnosis is not easy. We described a case of laryngeal squamous cell carcinoma presenting as a prelaryngeal large abscess. Markedly swollen false vocal fold inhibited fiberscopic examination of the vocal folds. CT scan indicated destruction of the thyroid cartilage. Although biopsies from the abscess did not reveal malignancy, laryngeal squamous cell carcinoma was confirmed by laryngomicrosurgery with laryngeal vestibulectomy. The patient was treated by total laryngectomy with neck dissection followed by radiotherapy. The abscess was thought to be formed not by direct extension and necrosis of the tumor, but by the leakage of air and mucus through the fistula on the destroyed thyroid cartilage. Precise observation and biopsy under directscopic vestibulectomy played an important role in diagnosis of malignancy inherent in severe inflammatory tissues.
Nakagawa
Hideki
H
Department of Otolaryngology, Seibo International Catholic Hospital, 2-5-1 Nakaochiai, Shinjuku-ku, Tokyo 161-8521, Japan. hnakagawa@seibokai.or.jp
Shiotani
Akihiro
A
Araki
Koji
K
Kusuyama
Toshiyuki
T
Fukuda
Hiroyuki
H
Ogawa
Kaoru
K
D000038:Abscess / Q000209:etiology* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D006801:Humans; D007818:Laryngeal Diseases / Q000209:etiology* / Q000601:surgery; D007822:Laryngeal Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy / Q000601:surgery; D007825:Laryngectomy; D007828:Laryngoscopy; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D037981:Neck Dissection; D018714:Radiotherapy, Adjuvant; D012086:Reoperation; D013290:Streptococcal Infections / Q000209:etiology* / Q000601:surgery; D034364:Streptococcus milleri Group; D014057:Tomography, X-Ray Computed