Liposarcoma of the head and neck – a rare case

Introduction:

Liposarcoma is a rare malignant soft tissue tumor of mesenchymal origin. It is the second most malignant soft tissue sarcoma after the pleomorphic sarcoma. Its typical localization is in the lower extermities. Only 4 – 9% of all liposarcomas present in the head and neck region. Fewer than 40 cases have been reported laryngeal/hypolaryngeal.

Case history/methods:

A 64-year-old patient was admitted to the hospital because of globus sensation and dyspnoea. The first endoscopic examination showed a spherical tumor of the left supraglottis involving the left aryepiglottic fold and false vocal cord. The glottis could not be assessed because of the tumor mass. The CT scan of the neck showed a tumor of the left hemilarynx. We performed a panendoscopy with a transoral laser tumor debulking in order to avoid a tracheostomy. The histological examination showed a pleomorphic liposarcoma. There were no metastases in the staging examinations. In accordance with the recommendation of the interdisciplinary tumor conference, we did a laryngectomy in order to achieve an R0 resektion, followed by an adjuvant radiotherapy. After 3 years of regular control examinations, the patient still remains without metastases or tumor relapse.

Conclusion:

As there are only a few cases of liposarcoma of the head and neck reported, the treatment has to be a individual decision. The objective is a surgical treatment to achieve a R0 resection and an adjuvant radiotherapy for high malignant tumors. A laryngectomy which allows a complete resection (radicality) versus a transoral larynxpreserving tumor resection (functionality) should be discussed. The use of chemotherapy remains controversial.

Publication History

Publication Date:
18 April 2018 (online)