title: Metastatic endometrial adenocarcinoma to the larynx: a case report and discussion of upper airway management.
abstract: OBJECTIVE
  The aim was to achieve endoscopic debulking surgery with regional low-dose radiotherapy as an alternative to tracheostomy for the management of metastatic endoluminal laryngeal tumor.
  
  
  BACKGROUND
  Endometrial adenocarcinoma rarely metastasizes to the head and neck region. Laryngeal metastases from endometrial adenocarcinoma are even rarer and usually indicate widespread disease. We present the case of a 55-year-old Asian woman with endometrial adenocarcinoma. She received radical surgical treatment and postoperative radiotherapy in April 2009. Fifteen months later, a solitary pulmonary lingual lobe metastasis was found and lobectomy was performed. The patient had hemoptysis another 15 months later, and a laryngeal endoluminal tumor was found by bronchoscopic examination. To prevent upper airway compromise, we performed transoral endoscopic debulking surgery with postoperative regional low-dose radiotherapy, instead of traditional tracheostomy. The patient underwent palliative chemotherapy after the surgery. After the intervention, the patient lived 19 months without upper airway obstruction.
  
  
  CONCLUSIONS
  According to the literature reviewed, this is the first case of endometrial adenocarcinoma with metastasis to the larynx. We here present this unique case and provide a less invasive treatment for upper airway obstruction. Without a tracheostoma, the patient's quality of life was greatly improved. Moreover, there was a reduced risk of lower airway infection.
  
  
  CONCLUSIONS
  We suggest endoscopic debulking surgery with regional low-dose radiotherapy as an alternative to tracheostomy for the management of metastatic endoluminal laryngeal tumors.
authors.affiliation: 1 Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital , Taipei, Taiwan .
authors.forename: Yi-Chan
authors.initials: YC
authors.lastname: Lee
authors.forename: Tuan-Jen
authors.initials: TJ
authors.lastname: Fang
authors.forename: Cheng-Tao
authors.initials: CT
authors.lastname: Lin
mesh_terms: D000230:Adenocarcinoma / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D058109:Airway Management / Q000379:methods*; D003131:Combined Modality Therapy; D016889:Endometrial Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011788:Quality of Life