2023 Volume 116 Issue 4 Pages 353-358
[Introduction] Desmoid tumors are benign, fibrous, soft-tissue tumors that arise from the connective tissue of the skeletal-muscles, myofascia, and aponeuroses, but rarely develop in the head and neck region. Herein, we report a patient with desmoid tumor of the larynx who was treated total laryngectomy.
[Patient] A 74-year-old male patient underwent laryngeal microsurgery for glottic cancer on the right-side (cTisN0M0). One year after the surgery, we detected swelling of the right vocal fold, and suspected recurrence of the cancer. Therefore, we performed laryngeal microsurgery to remove the right vocal fold. Histopathology revealed only scar tissue, and no evidence of any neoplastic lesion. The patient was then followed up at the outpatient department. However, the patient presented with breathing difficulty and was detected to have hypertrophy of the right vocal fold. Therefore, two years after the initial surgery, we performed tracheostomy. As with the previous biopsy, a tissue biopsy performed at this time again revealed no evidence of malignancy. The thickened tissue was extremely hard and scarred, making laryngeal microsurgery for total removal difficult. However, the right vocal fold continued to thicken gradually, eventually resulting in complete airway obstruction and dysphagia. CT examination revealed some low-density areas extending from the right vocal fold to the deeper areas. Four years after the initial surgery, therefore, we performed total laryngectomy. The histopathological diagnosis was desmoid tumor.
[Conclusion] The risk factors for desmoid tumors include traumatic factors, such as surgeries and fractures, and genetic factors. In our patient, it seems like the initial laryngeal microsurgery triggered the development of a desmoid tumor. We performed total laryngectomy because a sufficient resection margin was required. Many cases of recurrence of desmoid tumor have been reported; therefore, continuous follow-up of such cases is required.
