A rare case of a solitary laryngeal xanthoma and its clinical implications in a developing country like India
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20210177Keywords:
Laryngeal xanthoma, Vocal polyp, Vocal noduleAbstract
We present a rare case of a solitary laryngeal xanthoma in a 42 year old male, with complaints of hoarseness and change in voice since1 year. Direct laryngoscopic examination revealed a smooth textured polyp like mass arising from anterior 1/3rd of left vocal cord. No other similar lesions were noted anywhere else on his body. Microlaryngeal excision of mass was done and sent for histopathological examination, which showed fragments of stratified squamous epithelium with sub-epithelium displaying sheets of foamy cells. Immunohistochemistry was positive for CD68 and a diagnosis of solitary laryngeal xanthoma was arrived at. Follow up of the patient showed no recurrence but investigations revealed dyslipidemia, which was newly detected. Hence a diagnosis of a solitary laryngeal xanthoma, even without any other lesions, warrants a thorough investigative workup, including lipid profile, even in patients who are not known cases of dyslipidemia. This becomes especially important in a country like India, where a large number of cases of dyslipidemia go undetected; leading to atherosclerosis and even cardiac events in the future.
References
Parker F. Xanthomas and hyperlipidemias. J Am Acad Dermatol. 1985;13(1):1-30.
Matsumoto T, Nobukawa B, Kobayashi K, Watanabe M, Hosokawa A, Tomaru K, Ichikawa G. Solitary polypoid xanthoma in the larynx. Histopathology. 1999;34(5):475-7.
Perrone G, Zagami M, Casale M, Salvinelli F, Morini S, Rabitti C. Immunohistochemistry and differential diagnosis of a solitary flat laryngeal xanthoma: a case report. In vivo. 2007;21(1):119-21.
Jain AK, Jain S, Katarkar A, Alam N, Lakum N, Shah P, Modh D. A Rare Case of Sessile Polypoidal Xanthoma of Vocal Cord. 2012;2(2):66-8.
Vera-Sempere F, Collado-Martín D, Vera-Sirera B. Solitary Polypoid Laryngeal Xanthoma. Case Rep Otolaryngol. 2013;967536.
Kambič V, Radšel Z, Žargi M, Ačko M. Vocal cord polyps: incidence, histology and pathogenesis. J Laryngol Otol. 1981;95(6):609-18.
Rinaldo A, Mannarà GM, Fisher C, Ferlito A. Hamartoma of the larynx: a critical review of the literature. Annals of Otology, Rhinol Laryngol. 1998;107(3):264-7.
Hegde U, Doddawad VG, Sreeshyla HS, Patil R. Verruciform xanthoma: A view on the concepts of its etiopathogenesis. Journal of oral and maxillofacial pathology: JOMFP. 2013;17(3):392.
Park M, Boone B, Devos S. Xanthoma disseminatum: case report and mini-review of the literature. Actadermato venerologica Croatica. 2014;22(2):150-5.
Van Laer C, Hamans E, Neeten I, Van Marck E. Benign fibrous histiocytoma of the larynx: presentation of. J Laryngol Otol. 1996;110:474-7.
Gupta R, Rao RS, Misra A, Sharma SK. Recent trends in epidemiology of dyslipidemias in India. Ind Heart J. 2017;69(3):382-92.