Discussion
Sarcomas are rare and complex soft tissue tumors of mesenchymal origin; undifferentiated pleomorphic sarcoma is also known as (malignant fibrous histiocytoma) and it is the most prevelant type in adults, their incidence is high in the trunk, upper and lower limbs in patients between 50 – 70 years9-11, the median age of head and neck sarcoma incidence is 55-59 years12, head and neck sarcomas are uncommon with laryngeal being considered as rare tumor and not many cases reported in the literature9 sarcomas have different arrays of clinical presentations varies from small slow-growing lesions to invasive ulceration and wide histologic sub-types.13
Usually, the clinical presentation depends on the site of primary lesion and growth extent with hoarseness of voice being the first presenting symptom in tumor originating in the larynx, dyspnea, stridor are late symptoms meanwhile dysphagia is unlikely unless tumor extends into the hypopharynx. 13
TNM Staging of head and neck sarcomas differs from sarcomas arise in other parts of the body14, also histopathologic grade plays a significant role in prognosis in soft tissue sarcomas15, head and neck sarcomas tend to carry worse prognosis and lower 5 years survival rates than extremities and superficial trunk sarcomas as shown in one single institution series13, laryngeal sarcoma carries a better prognosis than other head and neck sarcomas in general16, but multiple other factors identified to play a role in overall survival and prognosis.
Soft tissue sarcoma’s treatment varies based on the site, surgical excision with or without post-surgical chemotherapy/Radiotherapy, Achieving a complete resection with negative margin in head and neck sarcomas might be difficult due to narrow anatomic spaces and close proximity to vital neurovascular structures, in laryngeal cancer with extensive T3 and T4a stages total laryngectomy will achieve better survival outcomes and quality of life for the patient.16
Surgical intervention remains superior to any other interventional modality used in the treatment of laryngeal sarcoma as showed in a systemic review of laryngeal sarcoma.16