Well-Differentiated Spindle Cell Liposarcoma of the Larynx in a Patient With a History of a Benign Laryngeal Lesion: A Case Report

TL;DR

This case report describes a rare laryngeal liposarcoma in a patient with a prior benign lesion, highlighting the importance of histologic evaluation for accurate diagnosis.

Contribution

The paper presents the second known case of laryngeal well-differentiated spindle cell liposarcoma with detailed diagnostic and treatment insights.

Findings

Laryngeal liposarcomas can mimic benign lesions and require histologic confirmation.

CD34 positivity and MDM2 amplification are key diagnostic features in this case.

Liposarcomas of the larynx have high recurrence rates and require postoperative surveillance.

Abstract

Liposarcomas of the larynx are an extremely rare occurrence. Though they are malignant, their presentation in the larynx may mimic benign conditions; therefore, diagnosis requires histologic evaluation. Our case represents the second known case of laryngeal well-differentiated spindle cell liposarcoma. The patient, a 74-year-old man, presented with dysphagia for two months with a history of a benign laryngeal lesion removed many years prior at another facility. His examination and operative evaluation were initially consistent with a recurrent internal laryngocele, but after pathologic evaluation, the diagnosis of well-differentiated spindle cell liposarcoma was made based on the histologic features as well as cluster of differentiation 34 (CD34) positivity, amplification of murine double minute-2 (MDM2) by fluorescence in situ hybridization (FISH), retained retinoblastoma (RB) protein expression, and negativity for signal transducer and activator of transcription 6 (STAT6). Treatment of these masses typically involves wide local excision, and because they have high rates of recurrence, postoperative surveillance is necessary as well. From this case, it can be concluded that liposarcomas of the larynx should be part of the differential diagnosis of laryngeal masses, even when they appear benign. Due to their rarity, research for risk factors as well as the prognosis of laryngeal liposarcomas is limited, and further studies are needed to better understand these topics and how they affect the diagnosis and treatment of laryngeal liposarcomas.

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