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Localized laryngeal amyloidosis: an unusual diagnosis in pediatric patients. Case report
Javiera Pardo Jadue1, Camila Ramírez Pelayo2, Andrés Lanas Volz1
1Department of Otolaryngology, Clínica Universidad de los Andes, Santiago, Chile.
Insights
Localized laryngeal amyloidosis is a rare condition in children. This case highlights effective diagnosis and surgical management using CO2 laser, with no recurrence after three years.
Area of Science:
- Otorhinolaryngology
- Pediatric Otolaryngology
- Pathology
Background:
- Localized laryngeal amyloidosis is exceedingly rare in pediatric patients, with limited global case documentation.
- Early recognition and intervention are crucial for managing this condition in young individuals.
Purpose of the Study:
- To present a rare case of localized laryngeal amyloidosis in a pediatric patient.
- To compare the diagnostic and management strategies with existing literature.
Main Methods:
- A 10-year-old male with progressive dysphonia underwent nasofibroscopy, CT imaging, and histopathology with Congo red staining.
- Systemic amyloidosis was excluded via serum biochemistry and echocardiogram.
- Surgical resection involved cold dissection and CO2 laser excision, followed by a three-year follow-up.
Main Results:
- Histopathological analysis confirmed localized laryngeal amyloidosis.
- Postoperative recovery was favorable, with minimal residual dysphonia and no dyspnea.
- Three-year follow-up revealed no significant disease recurrence, with a minor leukoplakia noted.
Conclusions:
- Localized laryngeal amyloidosis is a rare pediatric diagnosis requiring prompt identification.
- Transoral endoscopic resection is an effective surgical approach for symptom improvement.
- Long-term surveillance is essential due to the potential for recurrence within five years.
Purpose:
The primary objective of this study was to present a rare case of localized laryngeal amyloidosis in a pediatric patient, a condition with only 18 documented cases worldwide in individuals under eighteen years of age. Furthermore, it compares the diagnostic approach and management of this case with those outlined in the limited existing literature.
Methods:
A 10-year-old male patient presented with progressively worsening dysphonia. Clinical evaluation included nasofibroscopy, contrast-enhanced CT imaging, and histopathological examination of resected tissue. The histological diagnosis was confirmed using Congo red staining. Additional tests were conducted to rule out systemic amyloidosis, including serum biochemistry and echocardiogram. The patient was followed for three years postoperatively.
Results:
The patient was diagnosed with localized laryngeal amyloidosis, confirmed through histopathological analysis. Surgical management included a partial excision using cold dissection, followed by complete macroscopic resection with CO2 laser. Postoperative recovery showed minimal dysphonia with no dyspnea. Follow-up evaluations, including nasofibroscopy, revealed no significant recurrence of disease after three years, with only a small right posterior leukoplakia, interpreted as an impact-related lesion.
Conclusion:
Localized laryngeal amyloidosis is an rare condition in pediatric patients. Early diagnosis is critical, and surgical management via transoral endoscopic resection is effective in improving symptoms. Regular follow-up is necessary due to the high likelihood of recurrence, especially within the first five years.
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