title: Adenoid cystic carcinoma of the larynx presenting with unusual subglottic mass: Case report.
abstract: A 33-year-old woman presented with an unusual subglottic bulging mass accompanied by prolonged cough and wheeze. Laryngeal endoscopy revealed a bilateral, symmetrical mass immediately below the vocal cords with marked airway obstruction. Chronic subglottic laryngitis with inflammation or another condition such as amyloidosis was initially suspected. Cervicothoracic computed tomography revealed an obvious reduction of laryngeal caliber caused by an engulfing mass extending from just under the vocal cords to the cricoid ring, which was associated with thyroid, arytenoid, and cricoid cartilage destruction. Histopathological diagnosis of a biopsy specimen collected via a tracheotomy revealed that the lesion was a cT4aN0M0 adenoid cystic carcinoma (ACC) originating from the laryngeal minor salivary glands. The patient was treated by total laryngectomy with elective bilateral neck dissection under general anesthesia. Gross inspection of resected tissue confirmed yellowish-white, solid tumor mainly circumferentially encompassing the lumina of the cricoid ring. The histopathological findings confirmed typical ACC accompanied by a predominant cribriform appearance with no evidence of lymph node metastasis. The patient remains well and free of recurrence or metastasis. We herein describe laryngeal ACC and discuss radiological images and the surgical pathology.
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi 321-0293, Japan(1).
authors.forename: Takashi
authors.initials: T
authors.lastname: Kashiwagi
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi 321-0293, Japan(1). Electronic address: h-kanaya@dokkyomed.ac.jp.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kanaya
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi 321-0293, Japan(1).
authors.forename: Wataru
authors.initials: W
authors.lastname: Konno
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi 321-0293, Japan(1).
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Goto
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi 321-0293, Japan(1).
authors.forename: Hideki
authors.initials: H
authors.lastname: Hirabayashi
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi 321-0293, Japan(1).
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Haruna
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000209:etiology; D003528:Carcinoma, Adenoid Cystic / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D003371:Cough / Q000209:etiology; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D007825:Laryngectomy; D007828:Laryngoscopy; D037981:Neck Dissection; D012135:Respiratory Sounds / Q000209:etiology; D012468:Salivary Gland Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D012470:Salivary Glands, Minor / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed
keywords: Adenoid cystic carcinoma; Fiberscopy; Larynx; Prolonged cough; Subglottic mass