Chondrosarcoma of the hyoid treated with interstitial photodynamic therapy

Introduction

Primary cartilaginous tumors of the larynx are rare neoplasms. Chondrosarcomas constitute less than 1% of all laryngeal tumors. They are more commonly reported in Asian populations and have a 6:1 male/female ratio. Their clinical manifestation is often as painless unilateral cervical lymphadenopathy or as subcutaneous masses in the head and neck region.

Photodynamic therapy has previously been shown to reduce the bulk of tumours and vascular malformations.

Case report

A 74-year-old Caucasian male presented with asymptomatic, slowly enlarging swelling of the anterior neck. Radiological and histopathological investigation revealed a low grade chondrosarcoma of the hyoid bone and extending to involve most of the base of tongue and anterior laryngeal wall.

The patient was offered surgical excision of the sarcoma which would require sacrificing the larynx, base of tongue and the hyoid, but rejected. It was felt that other medical management (i.e. chemo-radiotherapy) was not the optimal choice.

Interstitial PDT was performed using a baseline MRI scan as a guide. Clinical and radiological assessments at follow-up showed a promising reduction in lesional size.

Conclusion

Conventional management of chondrosarcoma includes conservative, intra-lesional steroids, chemotherapeutic drugs, radiotherapy and surgical excision. Unfortunately none of which are curative as the lesion inevitably recurs. The authors commend PDT as a repeatable treatment option in management of these lesions.