Metastatic Sarcomatoid Carcinoma of the Larynx: A Case Report

Laryngeal spindle cell carcinoma (SpCC) is a unique and very aggressive form of laryngeal cancer. This neoplasm, consisting of malignant epithelial and mesenchymal elements, presents major diagnostic challenges, and there is a lack of conventional therapeutic approaches due to its rarity. This report describes a case of a 53-year-old female who experienced persistent difficulty speaking and a dry cough after contracting coronavirus disease 2019 (COVID-19). Histological and immunohistochemical studies confirmed the diagnosis of sarcomatoid cancer. Initially, the patient received cisplatin and doxorubicin-based chemotherapy. However, the tumor's growth prompted a change in treatment to weekly paclitaxel. Despite initial signs of improvement, the patient experienced acute alveolar hemorrhage, and sudden and severe bleeding in the small air sacs of the lungs, which unfortunately led to her death while receiving treatment in the critical care unit. The diagnosis and treatment of laryngeal SpCC pose significant challenges due to its uncommon and aggressive nature, and there is still no consensus on the most effective therapeutic approach. Existing therapies often incorporate modifications from other sarcoma regimes. Recent studies have demonstrated a possible positive reaction to immunotherapy, although further research is necessary to validate this. This report highlights the significant challenges of treating laryngeal sarcomatoid carcinomas and the importance of continued research to improve diagnostic and treatment options, especially given the absence of established guidelines.