Adult Laryngeal Rhabdomyoma with Extralaryngeal Extension: Surgical Excision and Reconstruction with Aortic Homograft

Objectives:1) Review the presentation, pathology, and treatment of rhabdomyomas. 2) Recognize the potential need for open resection with reconstruction as a treatment of benign laryngeal lesions in rare cases.Methods:A 67-year-old female presented with dyspnea and hoarseness. On examination she had a soft, mobile, centrally-located neck mass. Fiberoptic laryngoscopy revealed a large, submucosal supraglottic mass. Computed tomography (CT) showed a 3-cm supraglottic tumor with extralaryngeal extension. Needle aspiration suggested rhabdomyoma, confirmed by direct laryngoscopy with biopsy. She subsequently underwent awake tracheostomy, hemilaryngectomy, and reconstruction with aortic homograft. Pathology showed adult rhabdomyoma with representative large, polygonal cells with abundant cytoplasm, focal cross-striations, and occasional “strap” cells. Three weeks postoperatively she was decannulated and found to have a functional voice and swallow. After six months of follow-up she is without evidence of recurre...