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Anales de Otorrinolaringología Mexicana

2004, Number 3

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Otorrinolaringología 2004; 49 (3)

Vocal cord epidermoid carcinoma in childhood: a case report

Ferbeyre-Binelfa L, Pérez de Prado-Díaz J, Renó-Céspedes Js, Alert-Silva J, Llantá MC, Castellanos G

Language: Spanish
References: 31
Page: 46-52
PDF size: 102.70 Kb.


ABSTRACT

Larynx carcinoma in childhood is a rare condition. The diagnosis should be considered in any child with persistent hoarseness or cough. Delays in diagnosis are common, because the presenting symptoms are often mistaken for inflammatory or benign laryngeal disease. The disease has a similar behaviour in terms of squamous histology, predominant vocal cord involvement, local spread pattern and response to treatment; however, the incidence in females is higher in childhood (40% vs. 10% in adults), and children do not have the same risk factors as adults. We report the unusual case of a 12-year old boy with an epidermoid carcinoma of the glottic larynx, classified as T3 N0 M0 stage III. Literature revision is carried out. The patient presented with a 20-day history of hoarseness. The lesion proved to be a moderately well-differentiated epidermoid carcinoma. Neo-adjuvant chemotherapy was the treatment of choice in this case. A 90% partial response with normal cord mobility was obtained after three cycles of cisplatin and 5-fluorouracil. The patient started radiation therapy, and after receiving 1 600 cGy rapid tumour progression was evident, so he underwent radical surgery (11-27-02). The child is disease-free and totally rehabilitated after one year and four months of follow-up. Fifty-four cases have been reported in the anglosaxon literature since 1868. Treatment is problematic and prognosis unclear. Experience is limited to very few cases; nevertheless, radical surgery and postoperative radiation therapy have been the chosen treatment in the majority of reports, and chemotherapy has gained popularity lately.


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