Introduction:
Prostate carcinoma (PC) is the most common cancer among men. Generally PCA first metastasizes
to the lymph nodes and subsequently to the bones and organs. An infiltration of the
larynx is rare. We report about a patient who's first symptom of a PC with metastasis
was dysphonia.
Case report:
A 78-year-old patient presented himself due to hoarseness since several months. After
laryngoscopic examination we had the suspicion of a chronic laryngitis with a functional
component. Therefore we indicated a microlaryngoscopy (MLS) with biopsies. The histopathological
report revealed squamous mucosa with no evidence of malignancy. Six months later the
patient continued to complain of severe hoarseness during speech therapy. Postoperative
laryngoscopy showed an increase in swelling of the vestibular folds, vocal folds and
subglottic mucosa. Thus we suggested a Repitition-MLS. Deep samples of the vestibular
folds revealed histopathological an epithelial cancer, most likely matching to a metastasis
of a PC. Further diagnostics showed an elevated PSA of 1975 µg/l and a CT scan showed
an enlarged, inhomogeneous prostate, multiple suspicious retroperitoneal and iliac
lymph nodes as well as bone metastasis in the spine, pelvis and ribs. After presenting
him in the tumor board of the urologists, the colleagues recommended an androgen deprivation
(AT) therapy and a chemotherapy due to a PC with metastasis in the lymph nodes and
bones. Already under AT there was an improvement of the laryngeal swelling and the
dysphonia.
Conclusion:
In refractory dysphonia and laryngeal swollen mucosa, microlaryngoscopy should be
performed with a deep biopsy for histological confirmation. The differential diagnoses
should also include rare systemic diseases such as laryngeal metastasis of PC.
