Primary localized laryngeal amyloidosis presenting with hoarseness and dysphagia: a case report (original) (raw)

Laryngeal amyloidosis: a case report

International Journal of Otorhinolaryngology and Head and Neck Surgery, 2020

Amyloidosis is a rare, benign, slowly progressive disease characterized by extracellular accumulation of amyloid in different tissues of the body. It accounts for 0.2-1.2% of benign laryngeal tumors and usually presents as an isolated localized laryngeal amyloidosis, but can also be part of systemic amyloidosis. A 26 years old female with history of gradually developing, persistent hoarseness, and progressive dyspnea since 1 year, worsened over the past three days. Outpatient Department based endoscopy showed bilateral mobile, thickened vocal cords with subglottic edematous thickness. Computed tomography scan showed symmetrical thickening of bilateral vocal cord, causing glottic narrowing about 70% on the AP view and about 50% on the lateral view and no cartilage invasion or lymphadenopathy. Microlaryngoscopy and biopsy of the specimen were performed and histopathology confirmed the diagnosis of amyloidosis with Congo red stain. Patient was managed by surgical excision of the mass and long term follow-up. To rule out systemic amyloidosis patient is referred to rheumatology clinic and hematology clinic for further evaluation and management. Histopathological examination of the involved tissue confirms the diagnosis, and long term follow up is mandatory in the management of amyloidosis.

Primary Diffuse Laryngeal Amyloidosis, a Rare Cause of Hoarseness of Voice

https://www.ijhsr.org/IJHSR\_Vol.9\_Issue.11\_Nov2019/IJHSR\_Abstract.017.html, 2019

Introduction: Amyloidosis is a heterogenous group of disorders characterised by deposition of amyloid proteins in various body organs. Of the numerous types, Laryngeal Amyloidosis is an extremely rare disease of unknown etiology. Case report: We report a case of 30 year old woman who presented with hoarseness of voice and stridor necessitating a tracheostomy to secure the airway. A diagnosis of isolated laryngeal amyloidosis was made based on histopathology and thorough clinical and laboratory workup, and the patient responded to a combination therapy of oral corticosteroids and Bortezomib. Conclusion: Laryngeal amyloidosis is a rare disease, and its diagnosis calls for a high index of suspicion as well as thorough workup to exclude systemic involvement.

Primary Laryngeal Amyloidosis: A Case Report

International Journal of Otolaryngology and Head & Neck Surgery, 2017

Amyloidosis is a benign, indolent condition which presents with an abnormal deposition of extracellular protein in various organs of the body. It usually presents with hoarseness of voice to an otolaryngologist. A sits clinical appearance mimics an early laryngeal cancer. It remains a diagnostic challenge to the clinician. It is essential to differentiate a primary laryngeal amyloidosis from malignancy to have a holistic approach towards the management of the disease. Here in this article, a case is reported in order to have a better outlook about this rare condition and to differentiate it from laryngeal malignancy for an effective management and cure.

Isolated Laryngeal Amyloidosis

Iranian Journal of Otorhinolaryngology, 2013

Introduction: Amyloidosis comprises a heterogeneous group of disorders characterized by the deposition of amyloid protein in various organs of the body. The larynx is one of the rarer sites where amyloidosis occurs. Case Report: A 36-year-old man presented with a two-year history of hoarseness of voice. He had a positive history of smoking, but no history of long-term consumption of alcohol. Physical examination revealed a pinkish mass about 1.5× 1.5 cm in size on his left False Vocal Cord (FVC) extending to the left arytenoid, which resulted in asymmetry of the posterior larynx. He also had a chronic perforation of the right tympanic membrane with a conductive hearing loss consisting of a 50 dB gap in pure tune audiometry. The FVC mass was excised with a CO2 laser and on follow-up his voice got much better, but the hoarseness was not fully resolved. Conclusion: Amyloidosis of the larynx is a rare, usually benign process but the area is the most common site for isolated amyloid depo...

Laryngeal Amyloidosis: Case Series Of An Unusual Cause Of Hoarseness

Annals of International medical and Dental Research, 2017

Background: Amyloid can be defined as in in-vivo deposited amorphous material which on electron microscopy is fibrillar in appearance and gives apple-green birefringence on Congo-red staining. Beta-pleated sheet structure observed on X-Ray Diffraction is the characteristic finding. Deposition of this amyloid material in the human body interfering in the normal physiological functions of the body is called amyloidosis. Amyloidosis can be divided into localized or systemic form depending upon whether it is arising from proteins expressed by cells at the local site or they get deposited at different organs after production at a local site. Though amyloidosis can affect any organ of the body the most commonly affected organs include kidneys, heart and liver. In head and neck region macroglossia is the most common manifestation of amyloidosis. Laryngotracheal system is also one of the commonly affected site for localized amyloidosis. It usually appears as nodule or polypoid lesion in the larynx and constitute 1% of all benign laryngeal lesions. We present here a case series of 6 cases of laryngeal amyloidosis who presented to ENT department of our medical college and a leading ENT hospital in an urban area. Aims: To study the clinical presentation, examination findings, management and outcome of patients with laryngeal amyloidosis. Methods: This is a case series of 6 patients who presented to us with gradual change in voice. Detailed history was noted and clinical examination was done. Laryngoscopy was done in all cases. Later microlaryngoscopy and CO2 laser excision of polypoidal masses was performed under general anesthesia. Diagnosis was made on haematoxylin and eosin stain while confirmation was done by Congo red stain. Patient was discharged postoperative day 2 with broad spectrum antibiotics, analgesics and oral methylprednisolone for one week and was advised to take voice rest for five days. All patients were followed on seventh day, 1month, 3 months and 6months interval and thereafter yearly. Results: Patients included 4 females and 2 males with female to male ratio 2:1 their ages ranged from 40 to 70 years with mean age at presentation of 55 yrs. The most common age group involved was found to be 50-60 years. In majority of the cases (5/6) a single lesion was found while in 1 patient the lesions were multiple involving larynx and epiglottis also. In majority of the patients (50%) the duration of hoarseness was 1-2 years. successful microlaryngoscopy and CO2 laser excision was done in all the cases. All the patients were followed up regularly for a period of 5years. One patient showed recurrence after 3 years after first surgery the patient who developed recurrent disease had polypoidal and diffuse amyloid deposits. Conclusion: Laryngeal amyloidosis is a rare benign condition affecting larynx and should be suspected in any patient presenting with gradually increasing hoarseness of voice. It is diagnosed by characteristic birefringence under polarized light. It can be effectively treated by laser excision. Follow up is essential due to chances of recurrence

Laryngeal Amyloidosis- an Unusual Cause of Hoarseness: a Case Report

Journal of BP Koirala Institute of Health Sciences, 2019

Amyloidosis is a benign condition with abnormal deposition of extracellular protein in various parts of the body. Laryngeal amyloidosis is a rare clinical condition. Hoarseness of voice is one of the most common symptoms presenting to a clinician. The clinical appearance mimics the early laryngeal carcinoma. It remains a diagnostic challenge to the clinician. It is essential to differentiate laryngealamyloidosis from malignancy as most of the findings mimic laryngeal carcinoma. We report a case of laryngeal amyloidosis that presented with hoarseness, to differentiate it from laryngeal malignancy for effective management.

Two cases of primary laryngeal amyloidosis

JPMA. The Journal of the Pakistan Medical Association, 2009

The larynx is a rare site of involvement of amyloidosis. We report two cases of laryngeal amyloidosis. Both patients were middle aged females with history of persistent hoarseness. Fibreoptic laryngoscopy used for diagnosis in both and debulking of the tumour was performed. Histopathological examination confirmed the diagnosis of amyloidosis. Appropriate follow up is an important part of the long-term management of the disease.

Localized Laryngeal Amyloidosis

International Journal of Phonosurgery & Laryngology, 2016

Amyloidosis in head and neck is rare but a benign disease. Among the sites in head and neck, larynx is the most commonly involved. A 40-year-old female had presented with hoarseness of voice and dyspnea with a mass in false vocal cord, which was biopsied and diagnosed as amyloidosis. After excluding systemic diseases, final diagnosis of localized laryngeal amyloidosis was given. How to cite this article Baruah R, Khaund G, Kalita A. Localized Laryngeal Amyloidosis. Int J Phonosurg Laryngol 2016;6(1):32-34.

Localized laryngeal amyloidosis - a case report

Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2015

Amyloidosis encompasses a variety of conditions, caused by extracellular, insoluble protein fibrils that disturb the normal functioning of cells and organs. The disease may be localized or systemic, hereditary or acquired (associated with chronic inflammatory or hematological diseases). We present the case of a 49-year-old woman, with symptoms including dysphagia, dysphonia and dyspnea. After taking the case history and performing clinical examination, we suspected a laryngeal tumor to be the cause of the symptoms. Microlaryngoscopy and biopsy were performed. The histopathological examination result of the biopsy specimen was amyloidosis. Surgical excision of the tumor was performed. Our case presentation describes this rare pathological finding, its clinical manifestations, the histopathological and surgical diagnostic problems, treatment, patient evolution and the difficulties we encountered along the way, through the scope of our personal experience.