Pleomorphic Undifferentiated Sarcoma (Malignant Fibrous Histiocytoma) of True Vocal Fold: A Rare Laryngeal Malignancy

Abstract

Introduction

Pleomorphic undifferentiated sarcoma also known as Malignant fibrous histiocytoma, is a malignanat tumour which commonly involves upper and lower extremities and the retroperitoneum. Only a few sporadic MFHs located in the head and neck have been reported in the literature. Rarely the tumor can involve larynx. Complete excision of the tumor is the standard treatment but post-operative chemotherapy and / or radiotherapy is also recommended in selected cases.

Case Report

We present a rare case report of pleomorphic undifferentiated sarcoma also known as malignanat fibrous histiocytoma of true vocal fold in a 65 years old male patient. The patient presented to us with complaints of change in voice for past 3 months. He also reported about his smoking habits for past 35 years. On detailed examination of head and neck region no palpable lymph nodes were detected. Oral and nasal cavity examination also did not reveal any pathology. On endoscopic laryngeal assessment a polypoidal mass was seen arising from posterior half of anterior third of left true vocal fold. The vocal fold mobility was found normal.We completely excised the tumor by microlaryngeal surgery. The histopathological and immunohistochemical examination of the excised tissue identified the tumor being a pleomorphic undifferentiated sarcoma which was positive for Vimentin, EMA and negative for CK, p63. Patient did not receive radiotherapy/ chemotherepy in postoperative period. Patient has been under follow-up for past 6 months and is disease free as of now.

Discussion

Mesenchymal malignancies of larynx are rare entities. Pleomorphic undifferentiated sarcoma also known as malignanat fibrous histiocytoma is one of such malignancy. The treatment consists of complete excision of the lesion. The need of post-operative radiotherapy and/ chemotherapy depends on the extent of disease.