Laryngeal mycosis fungoides

Area of Science:

• Oncology
• Dermatology
• Pathology

Background:

• Mycosis fungoides is the most common type of cutaneous T-cell lymphoma.
• It typically presents as skin patches, plaques, or tumors.
• Extracutaneous involvement is uncommon, particularly in the initial presentation.

Observation:

• An 80-year-old female presented with a laryngeal tumor involving the arytenoid cartilage and epiglottis.
• Initial diagnosis suggested an undifferentiated small cell malignant neoplasm, treated with radiation.
• Two years later, widespread cutaneous mycosis fungoides, including a bullous form, developed.

Findings:

• The laryngeal tumor was histologically consistent with mycosis fungoides.
• The disease progressed over two years, leading to death.
• Autopsy revealed extensive visceral involvement by mycosis fungoides.

Implications:

• This case demonstrates that mycosis fungoides can rarely present initially in squamous epithelium-lined organs outside the skin.
• It underscores the importance of considering mycosis fungoides in the differential diagnosis of laryngeal tumors.
• The findings suggest a need for broader diagnostic considerations for mycosis fungoides beyond cutaneous manifestations.