PMC8077659_01
Coronal and axial neck CT scan with contrast.
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F1
Neck and thorax computed tomography (CT) scan with contrast (Fig. 1) showed a heterogeneously enhancing mass lesion in the left side of the larynx predominantly involving the glottic compartment and measuring approximately 1.8 x 1.5 x 1.1 cm in size.
Intraoperative image of the mass as it appears under micro-laryngoscopy.
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F2
The patient underwent micro-laryngoscopy (Fig. 2) with biopsy and debulking of the mass.
Low-power view of the tumor composed of pleomorphic malignant spindle cells. Note the overlying nonatypical squamous mucosa on the top right aspect of the image (HE, x10).
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F3
Specimen histopathology showed "fragments of partly ulcerated squamous mucosa with extensive underlying infiltration by a malignant neoplasm, composed of pleomorphic spindle cells, interspersed by numerous histiocytes." The malignant spindle cells exhibit frequent mitosis, including atypical mitosis; immunohistochemical stains were positive for smooth muscle actin (SMA), vimentin, and CD68 (in histiocytes), findings consistent with undifferentiated pleomorphic sarcoma (Fig. 3, 4).
High-power view of the tumor showing marked nuclear pleomorphism with frequent mitoses (black arrow) (HE, x40).
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F4
Specimen histopathology showed "fragments of partly ulcerated squamous mucosa with extensive underlying infiltration by a malignant neoplasm, composed of pleomorphic spindle cells, interspersed by numerous histiocytes." The malignant spindle cells exhibit frequent mitosis, including atypical mitosis; immunohistochemical stains were positive for smooth muscle actin (SMA), vimentin, and CD68 (in histiocytes), findings consistent with undifferentiated pleomorphic sarcoma (Fig. 3, 4).