Laryngeal Oncocytic Cystadenoma with Rare Location and Clinicopathological Aspects
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CASE REPORTS
Laryngeal Oncocytic Cystadenoma with Rare Location and Clinicopathological Aspects Ayşe Nur Uğur Kilinç1 · Yaşar Ünlü1 · Abitter Yücel1 Received: 1 April 2020 / Accepted: 5 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Laryngeal oncocytic cysts and cystadenomas are uncommon and observed in 0.1–1% of laryngeal biopsy specimens. A 66-year-old male was admitted to the hospital with a hoarse voice of 6 months duration. On laryngoscopic examination, a lesion of the left anterior vocal cord was present. It was excised by direct laryngoscopy and histopathologic examination revealed a cystic cavity with papillary projections into the lumen. The epithelial lining comprised bland oncocytic epithelium. These findings are characteristic of laryngeal oncocytic cystadenoma. Endoscopic excision is curative in these lesions. Oncocytic cystadenoma is a rare, cystic neoplasm that occurs in late adulthood. It may be considered in the clinicopathologic differential diagnosis of laryngeal lesions. Keywords Benign laryngeal lesion · Oncocytic adenoma · Hoarseness
Introduction Laryngeal oncocytic cysts and cystadenomas are rare, comprising 0.1–1% of laryngeal lesions. They tend to occur in the supraglottic region where the density of seromucinous glands is highest. A simple conservative endoscopic excision is curative with few instances of recurrence. Recurrence is attributed to diffuse or multifocal oncocytic metaplasia rather than aggressiveness [1, 2]. This report presents a rare case of cystadenoma in a patient presenting with hoarseness.
Case Report A 66-year-old male was admitted to our hospital for a hoarse voice of 6 months duration. On laryngoscopic examination, a 0.6 cm whitish lesion was present on the left anterior vocal cord. Axial T2-weighted magnetic resonance imaging showed a 6 × 5 mm hyperintense, cystic lesion with significant contrast enhancement in the left laryngeal ventricle (Fig. 1). Histopathologic examination demonstrated a cystic * Ayşe Nur Uğur Kilinç [email protected] 1
proliferation surrounded by loose connective tissue (Fig. 2a). The cystic spaces were lined by bland, oncocytic epithelium with occasional papillary projections into the lumen (Fig. 2b, c). The patient was diagnosed with papillary oncocytic cystadenoma. The patient had no complications during postoperative period is still followed up.
Discussion Laryngeal oncocytomas are rare, benign lesions. There are 32 reports describing 62 cases of laryngeal oncocytic cystadenomas in the English literature, with five cases reporting multifocal involvement [3]. Oncocytic cells are epithelial endocrine cells with high metabolic activity. They are known to be associated with inflammation, old age, and degeneration and may be found in the salivary, lacrimal, parathyroid, and thyroid glands [4]. The presence and number of oncocytes tend to increase with age [2]. Morphologically, the cells are large, cuboidal to columnar, and contain ample amounts of granular, eosinophilic cytoplasm. The
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