Laryngeal amyloidosis

Case contributed by Amy Wong

Presentation

Dysphonia in an ex-smoker. Left submucosal lesion arising from left laryngeal ventricle on laryngoscopy.

Patient Data

Age: 60 years
Gender: Male
ct
  • left supraglottic laryngeal mass 1.6 x 1.5 x 1.2 cm centered above glottis, obliterating left laryngeal ventricle, displacing left aryepiglottic fold medially.
  • no mass or suspicious asymmetry elsewhere within the upper aerodigestive tract
  • no cervical lymphadenopathy
Photo

Intraoperative photo demonstrating left well-defined submucosal lesion arising from the left laryngeal ventricle, clear of vocal fold and anterior commissure. 

Case Discussion

The patient underwent cold steel and shaver excision of the laryngeal lesion under general anesthesia. 

Histology: numerous deposits of homogenous eosinophilic material which stained salmon pink on congo red and showed apple-green birefringence, confirming amyloidosis. 

Case discussion

Amyloidosis is very rare and represents a heterogeneous group of disorders marked by abnormal protein formation and deposition which can cause organ failure and death. Up to 20% involve the head and neck, the larynx being the most common site of disease, representing 0.2-1.2% of all benign laryngeal tumors. Symptoms depend on the size and specific location of the deposit and may include dysphonia, dysphagia or exertional dyspnea. 

 

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