PMC3934772_01
The white arrow indicates the bulging lesion in the subglottic area on the left side of the larynx and the lesion involving the left arytenoid, which is part of the arytenoid-epiglottic fold causing the left vocal cord palsy.
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F1
Transnasal flexible endoscopy (fig. 1) revealed a smooth mass below the glottis distorting the larynx.
The white arrow indicates the heterogeneous lesion and the radiopaque spots representing the calcified lesion and suggesting cartilage or a bony nature.
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F2
A computed tomography (CT) scan of the neck revealed a solid mass in the supraglottic region, extending from the cricoid cartilage to the left thyroid cartilage area, with no neck lymphadenopathy (fig. 2).
a The infiltrated margin is showing a tumor beneath the epithelium and a normal mucosa with ciliated respiratory epithelium and squamous epithelium, HE stain, 40x. b The chondrocyte is multi-nucleus, the size does not differ much and mitosis is not obvious, which are all characteristics of low-grade chondrosarcoma, 200x. c Chondroid mixoid change representing the primitive proliferation along with the spindle cells, 100x. d Multiple cell nuclei in one lacuna and mitosis are shown, 200x.
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F3
Multiple biopsies were taken which revealed features consistent with low-grade chondrosarcoma (fig. 3c).
The subglottic lesion can hardly be seen in the subglottic area with forced inhalation.
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F4
The patient receives ambulatory treatment and is doing well, and transnasal flexible endoscopy revealed that his airway is relatively patent (fig. 4).