Leiomyosarcoma of the larynx as a local relapse of squamous cell carcinoma--report of an unusual case

Head Neck. 2010 May;32(5):679-83. doi: 10.1002/hed.21127.

Abstract

Background: The authors report on leiomyosarcoma after previously treated squamous cell carcinoma (SCC) at the glottis.

Methods: Primary tumor and relapses were investigated morphologically, immunohistochemically, and with molecular methods.

Results: The SCC was typical, but few cells showed a spindle-shaped pattern. The relapse tumor was a spindle-shaped and epitheloid tumor with the morphological and immunohistochemical appearance of leiomyosarcoma (sm-actin+, desmin+, caldesmon+, vimentin+, keratin-).The comparative genomic hybridization (CGH) revealed some gains and losses in the leiomyosarcoma. Because of altered material, the investigation failed in the primary. A fluorescence in situ hybridization (5p) focally detected 3 chromosmomal copies, corresponding to gains on 5p in CGH of leiomyosarcoma.

Conclusion: Leiomyosarcoma after SCC is very uncommon. A connection between both seems likely in this case. Transdifferentiation, also seen in other tumors or carcinosarcomas, could be based on aberrant differentiation of a pluripotent stem cell.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / surgery
  • Humans
  • Immunohistochemistry
  • Laryngeal Neoplasms / pathology*
  • Laryngeal Neoplasms / surgery
  • Leiomyosarcoma / pathology*
  • Male
  • Neoplasms, Second Primary / pathology*