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