Laryngeal osteosarcoma: a clinicopathologic analysis of four cases and comparison with a carcinosarcoma

We report the clinicopathologic findings of four cases of laryngeal osteosarcoma and one of carcinosarcoma with osteosarcoma components. The tumors occurred in men ranging in age from 50 to 69 years within a median age of 63.3 years. The most common symptoms were hoarseness, dyspnea, and obstruction, or a combination of these. Biopsy material and intraoperative frozen sections usually showed a high-grade sarcoma, but the diagnosis of osteosarcoma was quite apparent on microscopic examination of the surgical specimen. The primary differential diagnosis is spindle cell carcinoma with osteoid formation. Pulmonary metastases and local recurrences were common. Surgery is the treatment of choice, followed by adjuvant chemotherapy. Whether to use radiotherapy or not should be decided on an individual basis.