Multiple myeloma of the larynx – a case report

Introduction:

Severe and persistent dysphonia might be due to functional or tumorous reasons. In this case report we describe an unusual clinical case of dysphonia due to a rare tumor.

Case report:

An 81-year old patient was admitted in our hospital with dysphonia. Nicotine abuse was denied, a multiple myeloma was known in his medical history. The ORL examination revealed a reduced mobility of the right vocal cord and a thickening of the right vestibular fold, so that microlaryngoscopy was performed. The histological examination of specimens obtained from this region revealed a fibrosis. CT scans of neck and thorax was without any pathologies. The patient was discharged to outpatient care.

Three months later the patient presented with progressive dyspnea along with inspiratory stridor. The clinical examination revealed now a complete paralysis of the right vocal cord and a remaining glottic cleft of only 1 mm due to a supraglottic protrusion of the right vestibular fold. The CT scan showed a tumor of the right vocal cord extending to the right piriform sinus. After tumor debulking, histological and immonuhistochemical examination the diagnosis of a multiple myeloma was confirmed. The patient was treated with chemotherapy.

Conclusions:

Less frequent tumor entities of the larynx are neuroendocrine tumors, melanomas, sarcomas, and malignant lymphoma. The multiple lymphoma as a subentity of the indolent B-cell non-Hodgkin's lymphoma is very rare. Currently this tumor cannot be cured but a therapy has to be considered when it gets symptomatic. Chemotherapy showed a good response of the tumor in this case with complete remission.

Publication History

Publication Date:
18 April 2018 (online)