Carcinosarcoma of the Hypopharynx—A Rare Entity with Unique Surgical Procedure

Sangeet Kumar Agarwal, Satinder Singh, Shalabh Sharma, Asish Kumar Lahiri

Department of ENT and Head, Neck Surgery, Sir Ganga Ram Hospital, New Delhi, India.

DOI: 10.4236/ijohns.2013.26054                

Abstract

Background: Carcinosarcoma of hypopharynx is a rare neoplasm with both malignant epithelial and mesenchymal components. They are highly aggressive in nature with controversial histogenesis. To our knowledge, there is no case reported of carcinosarcoma of hypopharynx managed with wide LASER excision and modified radical neck dissection followed by chemoradiation. Method and Result: 42-year-old male presented complaints of foreign body sensation in throat, and difficulty in swallowing and hoarseness for 4 months. On examination, a large smooth globular mass filling the supraglottis obscuring the view of endolarynx was noted and right side level-II cervical lymphadenopathy was found. CECT neck revealed a large hypopharyngeal mass abutting the supraglottis. Microlaryngoscopic biopsy was reported as high grade carcinosarcoma and PET scan was done after 1 week which revealed no any distant metastasis. The patient was taken for transoral pulsed carbon dioxide LASER excision with modified radical neck dissection, and postoperative chemoradiation was done and after two years of closed follow-up MRI was done which revealed no disease and the patient is absolutely free of disease till now. Conclusion: It was a rare case which was managed with complete LASER excision with neck dissection and postoperative chemoradiation and the patient is absolutely free of disease till now after 2 years of follow-up.

 

Keywords

Carcinosarcoma; PET Scan; LASER

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	K. Luna-Ortiz and A. M. Taylor, “Supracricoid Partial Laryngectomy as a Primary Treatment for Carcinosarcoma of the Larynx,” Ear, Nose and Throat Journal, Vol. 85, No. 5, 2006, pp. 337-341.
[2]	K. D. Olsen, J. E. Lewis and V. J. Suman, “Spindle Cell Carcinoma of the Larynx and Hypopharynx,” Otolaryngology—Head and Neck Surgery, Vol. 116, No. 1, 1997, pp. 47-52. http://dx.doi.org/10.1016/S0194-5998(97)70351-6
[3]	J. C. Bull and O. F. Grimes, “Pulmonary Carcinosarcoma,” Chest, Vol. 65, No. 1, 1974, pp. 9-12. http://dx.doi.org/10.1378/chest.65.1.9
[4]	J. T. Au, G. Sugiyama, H. Wang, A. Nicastri, D. Lee, W. Ko and V. Tak, “Carcinosarcoma of the Esophagus—A Rare Mixed Type of Tumour,” Journal of Strength and Conditioning Research, Vol. 7, 2010, p. 7.
[5]	P. R. Lambert, P. H. Ward and G. Berci, “Pseudosarcoma of the Larynx,” Archives of Otolaryngology, Vol. 106, 1980, pp. 700-708. http://dx.doi.org/10.1001/archotol.1980.00790350042012
[6]	G. Randall, W. A. Alonso and J. H. Ogura, “Spindle Cell Carcinoma [Pseudosarcoma] of the Larynx,” Archives of Otolaryngology, Vol. 101, No. 1, 1975, pp. 63-66. http://dx.doi.org/10.1001/archotol.1975.00780300067018
[7]	F. Ianniello, E. Ferri, E. Armato, et al., “Carcinosarcoma of the Larynx: Immnohistochemical Study, Clinical Considerations, Therapeutic Strategies,” Acta Otorhinolaryngologica Italica, Vol. 21, No. 3, 2001, pp. 192-197.
[8]	D. Vie Vers, A. de Vito, K. Luna-Ortiz, et al., “Supracricoid Partial Laryngectomy for Non Squamous Cell Carcinoma of the Larynx,” Journal of Laryngology & Otology, Vol. 115, No. 5, 2001, pp. 388-392.
[9]	U. Srinivasan and G. V. Talyalkar, “True Carcinosarcoma of the Larynx: A Case Report,” Journal of Laryngology & Otology, Vol. 93, No. 10, 1979, pp. 1031-1035. http://dx.doi.org/10.1017/S002221510008806X