PMC3851004_01
Fiberlaryngoscopic finding that show a ACC of left vocal fold.
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F1
In fact, the fiberopticlaryngoscopy showed an hypertrophy of a left vocal fold, in the midline position, with a slightly uneven surface, ipsilateral hypoglottic region and subcommissurale region neoformation and narrowing of the lumen (Figure 1).
CT scan of larynx showing left vocal cord mass and destruction at left side of thyroid cartilage.
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F2
The subsequent cervicothoracic CT shows a nodular lesion of left part of larynx, associated with partial destruction of thyroid cartilage, cricoid ring to the left and ipsilateral arytenoid cartilage, in presence of bilateral cervical lymph node hyperplasy (Figure 2).
Total laryngectomy with functional bilateral lymph node excision of II-III-IV-V-VI level.
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F3
According to the clinical and radiologic data, the patient was submitted to a total laryngectomy with functional bilateral lymph node excision of II-III-IV-V-VI level (Figure 3).
The figures show adenoid cystic carcinoma deeply infiltrating the laryngeal mucosa. The tumour shows a predominant cribiform pattern, and is composed of pseudocysts, filled with basophilic mucin, surrounded by basaloid cells a, b.. Areas of intra-tumoural necrosis are also present. The lesion involves the cartilage (c) and the striated muscle (d) (Hematoxylin - eosin; a: 50X; b: 100x; c:200x; d:200x)
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F4
The pathological examination confirmed a adenoid cystic carcinoma deeply infiltrating the laryngeal mucosa, cricoid carticalgine and striated muscle tissue present, with a predominantly cribiform pattern, consisting of pseudocytos, filled with mucin basophilic basaliod cells, surrounded by areas of intra-tumoural necrosis and absence of cervical lymphnode metastases (Figure 4).