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Ian Ganly, MD; Snehal G. Patel, MD; Maria Coleman, BSc; Ronald Ghossein, MD; Diane Carlson, MD; Jatin P. Shah, MD

Arch Otolaryngol Head Neck Surg. 2006;132:767-770.

Objective  To report our experience in treating patients with malignant minor salivary gland tumors of the larynx.

Design  Thirty-three-year retrospective study.

Setting  Tertiary referral center specializing in head and neck surgery.

Patients  Twelve patients with malignant minor salivary gland tumors of the larynx were identified from a search of the institutional databases and pathology records at Memorial Sloan-Kettering Cancer Center, New York, NY, between the years 1970 and 2003. All slides were independently reviewed by 2 pathologists (R.G. and D.C.). Details on patient and tumor characteristics, as well as treatment and surgical outcome, were recorded.

Results  Ten patients (83%) had adenoid cystic carcinoma and 2 (17%) had myoepithelial carcinoma. Five (42%) were located in the supraglottis and 7 (58%) in the subglottis. Ten (83%) had surgery (6 with adjuvant radiotherapy) and 2 (17%) were treated with radiotherapy alone. Of the 10 patients who had surgery, total laryngectomy was required in 6 (60%), supraglottic horizontal laryngectomy in 2 (20%), and cricotracheal resection in 2 (20%). With a median follow-up of 55 months (range, 1-194 months), 10 patients are alive, 6 of whom have no evidence of disease. Seven patients (58%) developed recurrent disease, 2 of whom had local recurrence alone, 1 had regional recurrence alone, 3 had distant recurrence alone, and 1 had local and distant recurrence.

Conclusions  Up to 60% of patients with malignant minor salivary gland tumors of the larynx will develop recurrent disease locally, regionally, or at distant sites. In adenoid cystic carcinoma, regional recurrence is rare, but distant recurrence is common and may occur up to 10 years after the index therapy. For both adenoid cystic and myoepithelial carcinoma, partial surgery is possible in selected cases, but because of the high propensity for submucosal spread and perineural and lymphovascular invasion, total laryngectomy is usually recommended.

Author Affiliations: Head and Neck Service, Department of Surgery (Drs Ganly, Patel, and Shah and Ms Coleman), and Department of Pathology (Drs Ghossein and Carlson), Memorial Sloan-Kettering Cancer Center, New York, NY.