Laryngeal giant cell tumour

Recurrence of Giant Cell Tumor of The Larynx

Giant cell tumor of the larynx is a rare tumor. It was first reported by Wessely et al in 1940. Thirty-nine cases have been reported until now and together with the current case 2 recurrences were encountered. In this case report, our aim was to discuss conservative management because of the suspicion of recurrence. A 70-year-old male patient was admitted to our clinic with the complaint of hoarseness. A tumor measuring 1 × 1 cm located in the anterior half right vocal fold and extending to the anterior comissure was found on laryngeal endoscopy. Direct laryngoscopy and biopsy of the mass revealed giant cell tumor on histopathological examination. Tumor resection with cordectomy through laryngofissure and subsequently medialization thyroplasty were performed. Horaseness of the patient improved. On 2-year follow-up, a tumoral lesion suggesting recurrence was found on the vocal cord. Direct laryngoscopy and biopsy confirmed recurrence. Total laryngectomy was performed. This is the second case of recurrent giant cell tumor of the larynx. The therapy of choice should be selected considering the possibility of recurrence.

A large giant cell tumor of the larynx: case report and review of the literature

BACKGROUND

Giant cell tumors (GCTs) are typically found in the metaphyseal-epiphyseal area of long bones but can also occur in the head and neck region. GCT of the larynx is a rare entity with only 42 reported cases in the international literature. Furthermore, to the best of our knowledge this is the largest laryngeal GCT reported in the literature to date. GCT of the larynx can present with dysphonia, dyspnea, and/or dysphagia and should be considered in the differential diagnosis of a neck mass.

CASE PRESENTATION

This case report describes a giant cell tumor of the left thyroid cartilage in a 30-year-old man who initially presented with dysphonia and dysphagia. Computed tomography (CT) revealed a 5 × 5.7 cm mass centered on the left thyroid cartilage, which was further diagnosed by histopathology as giant cell tumour by open biopsy. The patient was counselled on treatment options and it was decided to proceed with a surgical approach. The patient consented to and successfully underwent a total laryngectomy (TL). Currently the patient has no evidence of disease at 13 months follow-up, has an optimal prosthetic voice, and is able to tolerate all textures of foods.

CONCLUSION

GCTs of the larynx have a good prognosis and can be treated successfully through complete resection of the tumor, negating the need for adjunctive therapy such as radiation, chemo or denosumab therapy.

Giant Cell Tumor of the Larynx Treated by Surgery and Adjuvant Denosumab: Case Report and Review of the Literature

Giant cell tumor of the larynx (GCTL) is a rare entity; only 34 cases have been reported in the literature. We report a case of GCTL in a 46 year-old male presenting clinical, radiographic, histological and therapeutic features. Previously reported cases are also reviewed.

Laryngeal giant cell tumor: a case report and review of the literature

Giant cell tumor (GCT) is a benign neoplasm arising most commonly in the long bones. GCTs of the larynx (GCTL) are relatively rare, and only individual case reports are documented in the literature. Patients with such tumors may present with hoarseness and anterior neck swelling. We present a 59-year-old man with hoarseness and enlarging anterior neck mass for 3 months. A fiberscopy revealed a submucosal swelling of the left subglottic trachea. Computed tomography and magnetic resonance imaging of the larynx demonstrated a large, well-defined, inhomogeneous enhancing mass at the left thyroid cartilage, which was obstructed entirely. The anterior neck mass was biopsied for histopathological analysis, which showed multinodularity with intervening vascularized connective tissues. The mass was made up of mononuclear cells and distributed multinucleated giant cells. The mitotic activity of the mononuclear cells was as high as 6 per 10 high-power fields. Pathologic consultation resulted in a diagnosis of giant cell tumor. The patient underwent total laryngectomy and, postoperatively, he did well without recurrence or metastasis for two and a half years.

Extraskeletal giant cell tumor of the larynx: case report and review of the literature

Giant cell tumors of the larynx typically arise within the laryngeal skeleton. We report a case of a laryngeal tumor in a 29-year-old man that clearly originated outside the laryngeal cartilage. It was identified as a soft-tissue giant cell tumor. To the best of our knowledge, an extraskeletal laryngeal giant cell tumor has not been previously reported.

Giant cell tumor of the larynx: a case report and review of the literature

Giant cell tumors are benign tumors commonly found in the long bones. Rarely, they may occur in the larynx, and patients with such tumors may present with hoarseness and anterior neck swelling. Since Wessely reported the first case of laryngeal giant cell tumor in 1940, 30 cases have been identified. Herein, we present a case of a 31-year-old man with giant cell tumor of the larynx successfully treated via the hemilaryngectomy approach.

Giant cell tumor of the larynx: a clinicopathologic series of eight cases and a review of the literature

True giant cell tumors of the larynx (GCTL) are quite rare, and only individual case reports are documented in the literature. Eight cases of GCTL were identified in the Otorhinolaryngic Pathology Tumor Registry between 1966 and 2000. There were 2 women and 6 men, ages 26 to 62 years (mean, 44.5 yrs). Patients presented with a palpable neck mass (n = 5), airway obstruction (n = 3), hoarseness (n = 3), and dysphagia (n = 2). All tumors involved the thyroid cartilage, a few with local extension. The mean tumor size was 4.1 cm. Histologically, the tumors showed no connection to the surface epithelium and arose in sites of ossification. The tumors had an expansile, infiltrative growth and consisted of numerous multinucleated osteoclast-like giant cells within a cellular stroma composed of plump, oval mononuclear cells. Of interest was that the nuclei of the giant cells were similar to the nuclei of the stromal cells. Treatment included biopsy only with adjuvant therapy (n = 2), local resection (n = 3), and total laryngectomy (n = 3). Follow-up showed 5 patients were alive without evidence of disease (mean follow-up, 6.9 yrs); 2 died of unrelated causes (mean survival, 22.2 yrs). No patients developed recurrences. GCTL are rare tumors that can cause significant airway obstruction. Complete surgical resection yields an excellent outcome without adjuvant therapy.

Giant cell tumor of the larynx

Giant cell tumors are benign tumors generally found in the long bones. Very rarely, they can occur in the larynx and may present with dysphonia, dysphagia, or dyspnea. A case of giant cell tumor of the larynx was recently identified and successfully treated by a partial laryngectomy. A literature review has revealed 18 case reports of giant cell tumor of the larynx. All cases occurred in men. These 19 cases are reviewed, and follow-up data presented where available. There have been no reports of recurrence regardless of treatment, and an excellent prognosis can be expected when one encounters this unusual laryngeal neoplasm.

Giant cell tumor of the larynx

Among the more uncommon tumors that may sometimes be encountered in the laryngeal region is the recently described giant cell tumor of the larynx. This lesion is a true neoplasm, presumably of the fibrohistiocytic series. Histologically, it closely resembles the more familiar true giant cell tumor of long bone. The laryngeal giant cell tumors appear, to date, to be nonmetastasizing lesions; it is possible that they may recur locally if incompletely excised (although this remains to be demonstrated). In view of the rarity of these tumors, a tentative diagnosis of such a neoplasm should always prompt consideration of other (more frequently encountered) differential diagnostic possibilities, including cytologically malignant giant cell-rich tumors such as malignant fibrous histiocytoma and sarcomatoid carcinoma.

Giant cell tumor of the larynx: case report and review of the literature

BACKGROUND

Primary manifestation of a giant cell tumor (GCT) in the larynx is exceedingly rare. Until now, only 17 cases have been reported in the literature. Characterization of a GCT can be difficult partly because of similarities with the giant cell subtype of malignant fibrous histiocytoma (MFH).

METHODS

The case of a 35-year-old man with a laryngeal GCT is presented. The patient underwent laryngectomy and has been free of recurrence since then (90 months). The literature is reviewed, and previously reported cases are presented in a table and compared with the presented case. The difficulties in the differential diagnosis are discussed.

CONCLUSIONS

When a laryngeal GCT is diagnosed, further differential diagnostic considerations should follow. One of these considerations is the MFH, which displays considerably more cellular atypia than GCT. Because most cases of giant cell MFH are high-grade sarcomas, the distinction between GCT and MFH is necessary.

Benign fibrous histiocytoma of the larynx: presentation of a case and review of the literature

A case of a benign histiocytoma of the larynx in a 39-year-old man is presented. Laryngeal fibrous histiocytoma is extremely rare. Its pathology is described including arguments for benignity. The literature is reviewed and management is discussed.

Giant cell variant of malignant fibrous histiocytoma of the head and neck

The giant cell variant of malignant fibrous histiocytoma is a rare entity in head and neck. Only eight well documented cases of this type are reported in the English literature. These tumours affect the superficial and deep structures of the neck most often and are best treated with prompt radical surgery. The prognosis of the giant cell type of malignant fibrous histiocytoma is dependent on the location of the tumour, with superficial tumours having a much better outlook.

Giant cell tumor of the bladder associated with transitional cell carcinoma

We report in detail the first giant cell tumor associated with transitional cell carcinoma of the bladder. The giant cell tumor was composed of multinucleated giant and mononuclear stromal cells, and was morphologically indistinguishable from giant cell tumor of the bone. The giant and transitional cell carcinomas showed no evidence of recurrence or metastasis 8 months after transurethral resection. No histogenetic correlation between the cancers was found.

Primary laryngeal malignant fibrous histiocytoma: review of the literature and report of seven cases

After describing 4 new cases of malignant fibrous histiocytoma of the larynx (3 cases had been recently published), the authors review the literature, from which it appears that 16 such lesions of the larynx have been reported (including their 7 cases). Malignant fibrous histiocytoma usually occurs in the soft tissues, tendons and joints of the upper and lower extremities, and is uncommon in the head and neck--though not exceptional. The lesion is a mesenchymal tumor probably of histiocytic origin and may be divided into 6 subtypes, i.e., pleomorphic, fibrous, giant cell, angiomatoid, myxoid and inflammatory, to be distinguished on the basis of the predominant feature. The tumor has an aggressive biologic behavior as it tends to recur and to metastasize to distant organs. The treatment of choice is surgery and adjuvant combination chemotherapy which at times may improve the survival rate.

Giant cell tumor of the ovary

A 31 year old woman with primary sterility was found, at operation, to have endometriosis of the Fallopian tubes and a giant cell tumor of the ovary, histologically indistinguishable from giant cell tumor of bone. The tumor is considered to be primary and benign, with a follow-up period of 4 1/2 years and no signs of recurrence or malignancy.

[Multinucleated giant cell tumor of the thyroid: an unusual anaplastic carcinoma (author's transl)]

Neoplasms of the thyroid with multinucleated, osteoclast-like giant cells, are rare. The numerous giant cells observed in these undifferentiated neoplasm have extensive eosinophilic cytoplasm and contain two to several hundred round or oval, uniform small nuclei. The clinical and morphologic data obtained from the two cases we describe and seven others collected from the literature are as follows: a) peak incidence in late adulthood; b) frequent association with a preexisting goiter (6 cases); c) rapid growth and fatal outcome within one year following diagnosis (5 cases); d) histologic pleomorphism with a background of uniform and spindle- or bizarre-shaped mononuclear cells; e) occasional coexistence of multinucleated giant cell tumor with well differentiated follicular carcinoma (1 case). Indirect evidence suggests that the multinucleated giant cells which characterize these unusual anaplastic carcinomas are epithelial in origin.