Metastatic endometrial adenocarcinoma to the larynx: A case report and discussion of upper airway management

Objective: The aim was to achieve endoscopic debulking surgery with regional low-dose radiotherapy as an alternative to tracheostomy for the management of metastatic endoluminal laryngeal tumor. Background: Endometrial adenocarcinoma rarely metastasizes to the head and neck region. Laryngeal metastases from endometrial adenocarcinoma are even rarer and usually indicate widespread disease. We present the case of a 55-year-old Asian woman with endometrial adenocarcinoma. She received radical surgical treatment and postoperative radiotherapy in April 2009. Fifteen months later, a solitary pulmonary lingual lobe metastasis was found and lobectomy was performed. The patient had hemoptysis another 15 months later, and a laryngeal endoluminal tumor was found by bronchoscopic examination. To prevent upper airway compromise, we performed transoral endoscopic debulking surgery with postoperative regional low-dose radiotherapy, instead of traditional tracheostomy. The patient underwent palliative chemotherapy after the surgery. After the intervention, the patient lived 19 months without upper airway obstruction. Discussion: According to the literature reviewed, this is the first case of endometrial adenocarcinoma with metastasis to the larynx. We here present this unique case and provide a less invasive treatment for upper airway obstruction. Without a tracheostoma, the patient's quality of life was greatly improved. Moreover, there was a reduced risk of lower airway infection. Conclusions: We suggest endoscopic debulking surgery with regional low-dose radiotherapy as an alternative to tracheostomy for the management of metastatic endoluminal laryngeal tumors.