Twin pathologies: synchronous leiomyosarcoma and squamous cell carcinoma of the larynx

The synchronous discovery of leiomyosarcoma (LMS) and squamous cell carcinoma (SCC) of the larynx is extremely rare. We describe our experience of managing a patient with this unusual presentation. A 35-year-old man was initially diagnosed with advanced stage (T_4bN₁M₀) laryngeal LMS. Neoadjuvant sarcoma-directed chemotherapy and radiation therapy allowed a successful pharyngolaryngo-oesophagectomy to be performed in an otherwise inoperable cancer. Histological examination of the resection specimen revealed poorly differentiated SCC, indicating the underlying diagnosis was a sarcomatoid carcinoma of the larynx. Considering our limited experience of managing synchronous LMS and SCC of the larynx, it is important to carefully evaluate the natural history, route of spread and pathological characteristics of both tumours, when determining treatment.