Benign, malignant or in between? Case report of a rare entity of the larynx

Introduction Amyloidosis of the larynx is a rare entity accounting for approximately 1% of all benign laryngeal masses, and the resulting neoplasia is even rarer. It is well known that amyloidosis is a pre-malignant lesion for non-Hodgkin's lymphoma, chronic lymphocytic leukemia and plasma cell neoplasia.

Case report In the present case, a 49-year-old man presented to our ENT outpatient clinic with prolonged hoarseness after an infection. The voice was assessed in the acute perceptive voice evaluation with R3B3H3, a glassy vocal fold polyp of the right vocal fold was visible in the flexible video endoscopy. In the subsequent microlaryngoscopy, the polyp is completely removed. The histologic examination results lead to the diagnosis: AL amyloidosis k-lead chain and an associated, plasmacytically differentiated B-cell neoplasia of unclear significance. Fortunately, the staging examination did not reveal any cardiac or renal involvement or any hematologic correlate; only an incipient polyneuropathy was considered to be associated.

Conclusion Harmless looking ENT masses may turn out to be rare entities and should therefore always be included in the differential diagnosis. The patient is currently well, the voice is significantly better 2 months postoperatively (R2B1H2), a hemato-oncological aftercare programm in thr form of wait&watsch is established.

Publication History

Article published online:
19 April 2024