Primary chondroid tumors of the larynx represent less than 1% of all laryngeal tumors. Most of them are chondromas and they often involve to the cricoid cartilage. A 31-year-old male patient applied to the oto-laryngology service with a history of dysphonia and dyspnea. Microlaryngoscopy revealed 2 cm sized, ill-defined, covered with regular mucosa, porous, and hard mass on posterior surface of crycoid cartilage in subglottic area. Following the excision of the lesion, histopathologic examination revealed as chondroma. Two years later, local recurrence was detected and the diagnosis was again chondroma. There was no complaint of the patient in last 3 and half years of follow-up. Chondroma should carefully be differentiated from chondrosarcoma and the patients should be followed for possible recurrences.
Cartilaginous tumors of larynx are very rare. Primary chondroid tumors of larynx are less than 1% of all laryngeal tumors [
The incidence of malignancy for chondroid tumors is higher in old patients. However chondromas were seen in 10-year younger patients than chondrosarcomas. Male : female ratio is 1 : 4 [
Cartilaginous tumors of larynx are classified in 4 groups [
A 31-years-old male patient was referred to the Chest Medicine Department with a history of dysphonia and dyspnea. Laryngeal subglottic mass was detected with bronchoscopic evaluation. The patient was consulted to the Department of Otolaryngology. 2 cm sized, ill-defined, porous, and hard mass on posterior surface of cricoid cartilage in subglottic area was detected in microlaryngoscopic evaluation. This mass was covered by regular mucosa. This lesion was scraped from posterior wall of cricoid cartilage with sickle scalpel. Mitomycine was applied to the lesion locally to prevent the development of postoperative scar. Clinically tracheostomy was not required and no complication was seen. He was discharged next day.
Macroscopically total volume of 2 cc, 0.2–0.5 cm sized, fragmented, gray-pink colored, medium-hardness, homogenous materials were seen. Microscopically well-defined, lobulated-contoured mass was seen near of the focally calcified cartilaginous tissue (Figure
Lobulated tumor near the calcified normal chondroid tissue. Hematoxylen Eosin stain ×50.
Hypocellular and homogenous appearance of tumor. Tumor cells are small, oval-round shaped (no mitosis and atypia). Hematoxylen Eosin stain ×100.
This patient was referred to the Department of Otolaryngology with stuck feeling in the throat after 2 years from first operation.
Chondroid tumors of the larynx are uncommon neoplasms and they are comprised up to 1% of all laryngeal neoplasms. However they are most common mesenchymal tumors of larynx [
Chondroid tumors of larynx can be easily recognized histologically, because of their characteristic features. But morphologic features must be well known for differential diagnosis between subtypes.
Chondrometaplastic nodules are smaller than 1 cm sized and multiple. This lesion is characterized by loose of lobular pattern, mucochondroid changes in soft tissue matriks, and well-defined nodules [
Differential diagnosis between chondromas and chondrosarcomas can be difficult. Macroscopically chondromas are smaller than 2 cm (average 1.5 cm) but chondrosarcomas are generally larger than 3 cm sized (average 4.3 cm) [
Increased cellularity (more than 40 nuclei/HPF), nuclear atypia, binucleation, mitosis, and pleomorphism are variable in low- and high-grade chondrosarcomas. Our lesion was characterized by hypocellularity, no nuclear atypia, mitosis, binucleation, and pleomorphism. We diagnosed this lesion as “laryngeal chondroma” with these morphologic findings. Our patient referred to the Department of Otolaryngology with recurrent mass in same localization after 2 years. Microlaryngoscopic resection of lesion was diagnosed as “chondroma” too. Routine follows-up (42 months) of patient have been normal.
Chondromas are rare mesenchymal tumors of larynx. They are benign lesions but incidence of locally recurrence is very high. Histopathologicly, differential diagnosis of laryngeal chondromas should be planned very carefully. Especially differential diagnosis between chondromas and low-grade chondrosarcomas is important for planning of treatment.
Laryngeal chondroma was described in a few numbers of reports.
We suggested that the differential diagnosis of chondromas must be done carefully and the follows-up of patients must be planned more frequently. Our case had typical clinical, histopathological, and prognostic features of laryngeal chondromas.