Spot diagnosis case 9

Scenario: This 56-year-old female with a history of COVID-19 pneumonitis and ICU admission visits the ENT outpatient clinic with a chronic cough and shortness of breath on exertion. Flexible laryngoscopy doesn’t show any abnormalities and there is normal vocal cord movement. There are some interesting findings on flexible tracheobronchoscopy.  

Questions:

1) What is the likely diagnosis?
2) What evidence of previous treatment do you see?

 

Spot diagnosis case 8 is now closed.

Scenario: This 65-year-old gentleman with a history of reflux disease presented with a sore throat, dysphonia and progressive shortness of breath over the past year.  He’s a never smoker. CT showed a mixed density mass in the subglottis with ‘popcorn’ calcifications and there is no invasion to adjacent soft tissue or bone. Pathology shows granular calcifications in multinucleated chondrocytes.

Questions:

1. What is the likely diagnosis? – Answer: low grade chondrosarcoma
2. What treatment would you recommend, and what are your considerations regarding treatment? – Answer: conservative if asymptomatic, endoscopic laser debulking if symptomatic, laryngectomy is reserved for large tumours in which surgery would cause destabilisation of the cricoid.