[A case of vascular leiomyoma in the larynx]

We report a recently encountered case of vascular leiomyoma in the larynx. The patient was a 76-year-old man with a chief complaint of hoarseness. Laryngoscopy revealed a bean-sized, reddish tumor with a smooth surface, suspended from the right vocal cord toward the subglottis. Its border was clear on MR imaging. Tracheotomy was performed under local anesthesia, and laryngomicrosurgery was then carried out under general anesthesia. The tumor was encapsulated and could be completely resected. Histological study indicated smooth muscule cell proliferation, especially around capillaries, and the tumor was diagnosed as a vascular leiomyoma. Our extensive survey of the literature revealed 20 reports of benign myogenic tumor of the larynx (9 cases of simple leiomyoma, 10 of vascular leiomyoma, and 1 of leiomyoblastoma), many of which occurred in the middle and advanced years. The patients consisted of 15 men and 5 women, including 9 male vascular leiomyoma patients of middle or advanced age. The site of occurrence was supraglottic in 12, glottic in 4 and subglottic in 4; no relation was observed with the histological picture, however. Treatment was surgical, and some cases also required tracheotomy depending on the site of occurrence and morphology.