A Rare Encounter: Case Report of Extraosseous Laryngeal Osteosarcoma

Background: Laryngeal sarcomas are a rare entity of all laryngeal neoplasms.Osseous tumors are exceptionally rare.Among these, extraosseous osteosarcoma of the larynx stands out as a rare but documented in literature malignancy.This entity has a varied presentation that depends on the tumor grade, rate of growth, local invasion, and spread.This report describes a 74-yearold male smoker with dysphagia, painful swallowing, and dyspnea due to primary osteosarcoma of the laryngeal vestibule.Case presentation: A 74-year-old patient, a smoker (33 pack-years), is referred to the Department of Otorhinolaryngology for the onset of odynophagia and dysphagia for unspecified months; he also reports the onset of dyspnea over the past 7 days.Nasopharyngeal and laryngeal endoscopic examination reveals a non-ulcerated exophytic sessile neoformation on the laryngeal surface of the infrahyoid epiglottis, obliterating the laryngeal vestibule with significantly reduced respiratory space.Preoperative contrasted computed tomography scan of the neck showed swellings of the walls of the pharynx and laryngeal vestibule with a very reduced respiratory glottic space.Transoral microlaryngoscopy excision was conducted using the CO 2 laser.The histopathologic study of the surgical specimen revealed a malignant spindle cell neoplasm, the morphological characteristics of which are consistent with the diagnosis of sarcomatoid carcinoma with metaplastic aspects, grade III according to the Fdration Nationale des Centres de Lutte Contre le Cancer (FNCLCC), pT2 Nx Mx according to Tumors Nodes Metastasis (TNM)/American Joint Committee on Cancer (AJCC) 8th edition, 2017.Conclusion: This report has highlighted the challenging diagnosis of a rare tumor, primary osteosarcoma of the larynx, and the approach to diagnosis and management.Surgical excision, guided by precise preoperative planning and histopathological examination, remains a key component of the treatment strategy.