Larinksin az görülen skuamöz hücreli karsinom varyantları: tek merkeze ait 7 yıllık deneyim

Larinksin malign epitelyal tümörleri arasında skuamöz hücreli karsinom en sık görülendir. Daha çok erkeklerde, 6. ve 7. dekadlarda görülür. Son yıllarda tütün ve alkol kullanımının artması nedeniyle kadınlarda da insidansının yükseldiği bildirilmektedir. Skuamöz hücreli karsinom supraglottik ve glottik bölgede daha sık görülür. Dünya Sağlık Örgütü, skuamöz hücreli karsinomun farklı alt tiplerini tanımlamıştır. Bu varyantlardan bazıları konvansiyonel skuamöz hücreli karsinoma göre daha iyi, bazıları ise daha kötü prognozludur. Çalışmamızda skuamöz hücreli karsinomun az görülen varyantları sunulmaktadır.Gereç ve Yöntem: … Tıp Fakültesi Patoloji Anabilim Dalı’nda son 7 yıllık dönemde tüm larinks biyopsileri taranmıştır. Skuamöz hücreli karsinom varyantları şeklinde tanı alan hastalar belirlenmiş, olguların histopatolojik ve klinik özellikleri derlenmiştir.Bulgular: Yedi yıllık dönemde larinks biyopsisi yapılan 1148 olgu bulunmaktadır. Bu olgulardan 460’ı skuamöz hücreli karsinom tanısı almıştır. Bunlardan 31’i nadir görülen skuamöz hücreli karsinom varyantıdır. Bunlar arasında 3 verrüköz karsinom, 6 bazaloid, 11 papiller, 4 iğsi hücreli, 6 akantolitik varyant skuamöz hücreli karsinom olgusu mevcuttur. Bir olgu ise adenoskuamöz karsinom tanılıdır. Verrüköz karsinom olgularında tümör vokal kord yerleşimlidir. Bazaloid varyant ise olguların tümünde supraglottik bölgede saptanmıştır. Diğer varyantlarda glottik ve supraglottik bölge değişen oranlarda tutulmaktadır. Olguların sadece birinde infraglottik tümör mevcuttur. Bu olgu akantolitik varyant skuamöz hücreli karsinom olarak değerlendirilmiştir. Sonuç: Larinksin skuamöz hücreli karsinomunun az görülen varyantlarının biyolojik davranışları farklılıklar göstermektedir. Bu tümörler multidisipliner yaklaşım ile efektif şekilde tedavi edilebilir. Alt tiplerin tanınması ve tariflenmesi uygun tedavi yaklaşımının belirlenebilmesi için gereklidir.

Anahtar Kelimeler:

Larinks, skuamöz hücreli karsinom, nadir varyantlar

Rare squamous cell carcinoma variants of the larynx: 7 years experience of one center

Squamous cell carcinoma is the most common malignant epithelial tumor of the larynx. It is mostly seen in males in 6th and 7th decades. In recent years the incidence has increased in women due to increased use of tobacco and alcohol. Squamous cell carcinoma is more common in supraglottic and glottic regions. The World Health Organization has identified different subtypes of squamous cell carcinoma. Some of these variants has better, some has worse prognosis that than conventional squamous cell carcinoma. We present rare variants of squamous cell carcinoma in our study.Material and Method: All laryngeal biopsies were scanned at the Pathology Department of Eskişehir Osmangazi University during the last 7 years. The cases that were diagnosed as squamous cell carcinoma variants were included in the study. Patients’ histopathological and clinical parameters were recorded.Results: There were 1148 laryngeal biopsies in the seven years period. Squamous cell carcinoma was detected in 460 cases. Of these, 31 were rare squamous cell carcinoma variants. These include 3 verrucous carcinomas, 6 basaloid, 11 papillary, 4 spindle cell, 6 acantholytic variant squamous cell carcinomas. Only one case was adenosquamous carcinoma. Verrucous carcinomas were located on the vocal cord. The basaloid variant was detected in supraglottic region in all cases. In other variants, the glottic and supraglottic regions were affected at varying rates. Infraglottic tumor was seen in only one of the cases. This case was acantholytic variant squamous cell carcinoma. Conclusion: Biological behaviors of rare variants of laryngeal squamous cell carcinoma differ. These tumors can be treated effectively with a multidisciplinary approach. Recognition and description of these subtypes are necessary to determine the appropriate treatment.

Keywords:

Larynx, squamous cell carcinoma, rare variants,

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