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|Year : 1979 | Volume
| Issue : 2 | Page : 115-116
Laryngeal adenoidcystic carcinoma
RC Mankodi, RM Shah
Departments of Pathology and Surgery, Dr. B. Nanavati Hospital, Vile-Parle (West), Bombay-400 056, India
R C Mankodi
Departments of Pathology and Surgery, Dr. B. Nanavati Hospital, Vile-Parle (West), Bombay-400 056
Source of Support: None, Conflict of Interest: None
A 72 year old male patient was admitted with complaints of dyspnoeaa of two months' duration. On local examination of 'he larynx, a polypoidal growth was seen in the sub glottis. Biopsy report was adenoid cystic carcinoma. Total laryngectomy was carried out. Post-operative course was uneventful. Occurrence of adenoid cystic carcinoma in the region of sub glottis is rare.
|How to cite this article:|
Mankodi R C, Shah R M. Laryngeal adenoidcystic carcinoma. J Postgrad Med 1979;25:115-6
| :: Introduction|| |
Adenoidcystic carcinoma (or cylindroma as formerly called) is relatively uncommon tumour of disputed histogenesis.  Characteristically the tumours have a well differentiated and distinctive histologic appearance. In head and neck regions, they commonly arise from salivary tissue. Occurence of tumour in non-salivary tissue especially in larynx is quite rare.
Certain interesting features and rarity of its occurence prompted us to report this case.
| :: Case report|| |
A 72 year old male was admitted to the Dr. Balabhai Nanavati Hospital, Bombay for dyspnoea of two months' duration. Earlier he was treated as a case of `bronchial asthma' with no relief. On examination, all his systems were found normal. There was no lymphadenopathy. Liver and spleen were normal. Investigations revealed haemoglobin to be 10 gin. per cent and total leucocyte count of 10,200 per cu.mm . His ESR was 32 mm after first hour (Westergren). Plain X-Ray of the chest was normal.
On laryngoscopic examination, a polypoidal growth was seen in the subglottic area, about one cm. below the level of the vocal cord. Biopsy of the growth revealed it to be adenoid cystic carcinoma. Total laryngectomy -was done and the specimen was studied pathologically.
Gross: Specimen consisted of larynx measuring 8 x 4 cms. On cutting open, it showed a well defined polypoidal growth on the right lateral wall of the inferior (subglottic) larynx. Vocal cords appeared normal. Tumour was covered with smooth mucosa and it was soft in consistency (See [Figure 1] on page 116A).
Microscopic examination: It showed solid groups of small dark staining lymphocytoid cells with scanty cytoplasm. Cords of cells were separated by hyaline stroma. Cells showed only occasional mitosis. On more sections, perineural invasion could be seen. Tumour was lined by pseudostratified squamous epithelium (See [Figure 2] on page 116A).
Diagnosis of adenoid cystic carcinoma was confirmed.
| :: Discussion|| |
The tumour showed classic histologic appearance. Its occurrence in the sub- glottic area is a rare feature, Fine et al  in their series of 108 cases of adenoidcystic carcinoma, did not come across a single case involving larynx. Recently, Conley and Dingman  also reported a series of 134 cases but not a single in the larynx. This tumour, though not invasive, has a high rate of recurrence. Perineural spread could be demonstrated in the present case. Over 51 per cent of the tumours in the series of Luna et al  (quoted by Busutill, 1977  ) showed neural invasion. In the present case, postoperative course was uneventful.
| :: Acknowledgement|| |
Authors are thankful to Dean Dr.S. C. Sheth for allowing us to publish this case report.
| :: References|| |
|1.||Busuttil, A.: Adenoid cystic carcinoma of minor salivary g'ands. J. Laryngol. & Otol, 91: 41-53, 1977. |
|2.||Conley, J. and Dingman, D. L.: Adenoidcystic carcinoma in the head and (Cylindromee). Arch. Ot:olaryngol., t9 i 81-90, 1974. |
|3.||Fine, G., Marshall, R. B. and Horn, R. C.: Tumours of salivary glands. Cancer, 13: 653-669, 1960. |
|4.||Foote, F. W. Jr. and Frazell, E. L.: Tumours of major salivary glands. Cancer. 6: 1065-1133, 1953. |
|5.||Luna, M. A., Stimson, P. G. and Bardwill, J. M.: Minor salivary gland tumours of the oral cavity-A review of 68 cases. Oral Surgery, Oral Medicine and Oral Pathology, 25: 71-86, 1968 |
[Figure 1], [Figure 2]