Patient presented as a 74-year-old male complaining of hoarseness. Electronic laryngoscope showed a neoplasm whose size was about 1.0 cm×0.5 cm×0.5 cm at anterior commissure. A surgery was conducted to excise the neoplasm en bloc. The histopathological and immunohistochemistry examination suggested inflammatory myofibroblastic tumor. A month later, the patient presented with dyspnea and blood-stained sputum. CT scan of neck showed an occupation lesions under glottis. A tracheotomy and a CO₂ laser surgery was conducted due to patient's will. The histopathological and immunohistochemistry examination suggested undifferentiated sarcoma. We advised him keeping a tracheal cannula to receive further treatment such as radiotherapy or chemotherapy in oncology department, but the patient was not compliant with care instructions for personal reason. He was readmitted 2 months later for dyspnea after plugging the tube. Electronic laryngoscope showed a large neoplasm occupied the laryngeal vestibule, covering the glottis. CT and MRI scan showed the lesion involved spaces of supraglottic, glottic, subglottic and soft tissue around larynx. Hence, a total laryngotomy and bilateral functional neck dissection was conducted. The histopathological examination agreed with the former one. Three weeks later, the skin around his tracheal cannula swelled,ulcerated and pyorrheal. After 10 days of dressing change, patient died of uncontrolled infection.
Keywords: diagnosis; head and neck neoplasms; soft-tissue sarcoma; therapy.
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