Adenosquamous carcinoma of the larynx: impact of the unusual phenotype on definitive treatment. A case report.
Journal: Advances in Medicine and Engineering Interdisciplinary Research DOI: 10.32629/ameir.v3i4.4860
Abstract
The malignant laryngeal tumors include a variety of histological types with different biological characteristics, and therefore require a different therapeutic approach and lead to a variety of prognosis. Clinical case: we present a case of adenosquamous carcinoma of the larynx, in a 57-year-old male patient who, since July 2016, has presented progressive dysphonia. He goes to a foreign doctor, who evaluates him and performs nasofibrolaryngoscopy, evidencing glottis tumor, and refers to this center. He is evaluated and direct laryngoscopy plus biopsy is performed, classified as cT3N1M0 stage III, total laryngectomy plus bilateral modified radical cervical dissection is performed in 2017, subsequently referred to the radiotherapy and medical oncology service, and he receives adjuvant concurrent chemo radiation therapy, the patient remains disease free to the date. Discusion: it is an extremely rare neoplasm, whose histological characterization is distinctive, due to the presence of mixed areas of unequivocal adenocarcinoma and the squamous cell carcinoma. The combined surgery and the additional adjuvant radiotherapy found to be necessary because the biological behavior and prognosis of this neoplasm considered more aggressive than those of conventional squamous cell carcinoma are. There is no standardized treatment; it based on the possibility of the surgical resection, whose extension resulted from tumor infiltration into the adjacent structures, followed by concurrent radiotherapy or chemo-radiation therapy.
Keywords
cancer; larynx adenosquamous; head and neck; surgery; radiotherapy; chemotherapy
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[6] IARC Working Group on the evaluation of carcinogenic risks to humans. Human papillomaviruses. IARC Monogr Eval Carcinog Risks Hum. 2007;90:1-636.
[7] Mehanna H, Jones T, Gregoire V, Ang K. Oropharyngeal carcinoma related to human papillomavirus. BMJ. 2010;340:c1439.
[8] Nocioni R, Molteni G, Mattiuzi C, Lippi G. Updates on larynx cancer epidemiology. Chin J Cancer Res. 2020;32(1):18-25.
[9] Orellana M, Chuang A, Fulle A, Fernández R, Loyola F, Imarai C. Cáncer de laringe: serie de casos en 6 años en el Complejo Asistencial Doctor Sótero del Río. Rev Otorrinolaringol Cir Cabeza Cuello. 2017;77(1):35-43.
[10] Contreras P, Muñoz D, Contreras J, Rahal M. Momento de inicio de radioterapia posoperatoria como factor pronóstico en pacientes con cáncer de laringe avanzado. Rev Otorrinolaringol Cir Cabeza Cuello. 2018;78:406-412.
[11]Amin M, Edge S, Greene F, Compton C, Gershenwald J, Brookland R, et al. AJCC Cancer Staging Manual. 8. edición. Nueva York: Springer International Publishing; 2017.
[12] Steuer C, El-Deiry M, Parks J, Higgins K, Saba NF. An Update on larynx cancer. CA Cancer J Clin. 2017;67(1):31-50. https://doi.org/10.3322/ caac.21386.
[13] Dubal PM, Unsal AA, Echanique KA, Vazquez A, Reder LS, Baredes S, et al. Laryngeal adenosquamous carcinoma: A population-based perspective. Laryngoscope. 2016;126:858-863.
[14] Gale N, Zidar N, Cardesa A, Nadal A. Benign and potentially malignant lesions of the squamous epithelium and squamous cell carcinoma. En: Cardesa A, Slootweg PJ, Gale, Franchi A, editores. Pathology of the head and neck. Berlin: Springer;2016. p.1-48.
[15] Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. F. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359-E386. doi: 10.1002/ijc.29210.
[16] Graboyes E, Zhan K, Garrett-Mayer E, Lentsch E, Sharma A, Day T. Effect of Postoperative radiotherapy on survival for surgically managed pT3N0 and pT4aN0 laryngeal cancer: Analysis of the National Cancer Data Base. Cancer. 2017;123:2248-2257. https://doi.org/10.1002/cncr.30586.
[17] Wolf GT, Bellile E, Eisbruch A, Urba S, Bradford CR, Peterson L, et al. Survival rates using individualized bioselection treatment methods in patients with advanced laryngeal cancer. JAMA Otolaryngol Head Neck Surg. 2017;143:355-366.
[18] Pradenas M, Vallejos M, Rahal M, Cisternas A. Cáncer de laringe e hipofaringe. Experiencia del Hospital Barros Luco Trudeau 1990-2001. Rev Otorrinolaringol Cir Cabeza Cuello. 2004;64:13-20.
[19] Passon P, Tessitori G, Lombardo M, Callea S, Poli, P. Long-surviving case of adenosquamous carcinoma of the larynx: Case report and review of literature. Acta Otorhinolaryngologica Italica. 2005;25(5):301-303.
[20] Skóra T, Nowak-Sadzikowska J, Mucha-Malecka A, Szyszka-Charewicz B, Jakubowicz J, Glinski B. Postoperative irradiation in patients with pT3-4N0 laryngeal cancer: Results and prognostic factors. Eur Arch Otorhinolaryngol. 2015;272(3):673-679.
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