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class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Deysi Barbara" "apellidos" => "García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Francisco" "apellidos" => "Crego" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Ángel" "apellidos" => "Serrano" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Otorrinolaringología, Hospital General de Granollers, Granollers, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Radiología, Hospital General de Granollers, Granollers, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital General de Granollers, Granollers, Barcelona, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Adenocarcinoma de laringe con metástasis en el pene" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 885 "Ancho" => 1500 "Tamanyo" => 190228 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Computed tomography. (B) Macroscopic imaging of the laryngeal tumour.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Clinical Case</span><p id="par0005" class="elsevierStylePara elsevierViewall">Patient aged 68, a smoker who presented with a 15-day history of haemoptysis with moderate dysphagia, vesicular voice disorder, weight loss, voiding syndrome and priapism. Examination showed an epiglottis laryngeal side tumour (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) with bilateral cervical swollen lymph nodes under 6<span class="elsevierStyleHsp" style=""></span>cm and the cervical and chest CAT scan showed a new nodular formation of 4<span class="elsevierStyleHsp" style=""></span>cm in the epiglottis, with bilateral metastatic swollen lymph nodes (stages IIa, IIb, IIIb and IVa right and stage IIa left). There were no changes in the region of the chest. The biopsy study reported a moderately differentiated infiltrating adenocarcinoma.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Cystoscopy ruled out any bladder tumours and urological clinical studies suggested a urethral infection with possible involvement of infection and inflammation in the corpus cavernosum penis. An ultrasound study of the penis showed a hypoechogenic focal area of 7<span class="elsevierStyleHsp" style=""></span>mm of the middle margin of the left corpus cavernosum with poor wall markings, swelling and hypoechogenicity of the surrounding tunicas albugineas. Differential diagnosis was suggested as either intracavernosum boil-abscess or metastasis, and fine-needle aspiration was thus performed. When no material was obtained a biopsy was made which reported metastasis from adenocarcinoma with the same morphological and immunohistochemical characteristics as the previously diagnosed laryngeal adenocarcinoma (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">A PET-CAT scan showed a hyper-enhanced suprahioid mass in the suprahioid epiglottis with involvement into the pre-epiglottal space and laterocervical bilateral and mediastinal swollen lympth nodes. The lung was observed to have nodes which were slightly hypermetabolic in LUL and RML. Final diagnosis was adenocarcinoma of the epiglottis, T2N2cM1, stage <span class="elsevierStyleSmallCaps">IVC</span>. In mid diagnosis tracheotomy was performed due to dyspnoea. Oncologically this was a widespread disease which required systemic treatment with palliative chemotherapy. The patient died 3 months after diagnosis.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Discussion</span><p id="par0020" class="elsevierStylePara elsevierViewall">Laryngeal adenocarcinoma has an incidence of under 1% of malignant laryngeal neoplasias,<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> and usually presents in males who are smokers in their 60s or 70s. Clinical symptoms are identical to other laryngeal tumours (dyspnoea, dysphonia, dysphagia or odynophagia). Regarding Spain, one case in Galicia has been reported in this same journal in 2008.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">This type of tumour is highly aggressive, with a tendency to metastasize both locally and to other parts of the body, as observed in the case we present. 75% of cases begin with lymph node involvement, and 46% with distant metastasis, and for this reason they are usually diagnosed in advanced stages.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> Furthermore, prognosis is worse than squamous cell carcinoma with the same stage and topography.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> Metastasis in corpus cavernosum, which is rare in other tumours,<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">5,6</span></a> is the first case reported in a laryngeal tumour and we have found no case similar to ours in the literature.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Adenocarcinoma starts in the minor or serous and mucus salivary glands of the laryngeal submucous.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> Considering this origin, the most extensive review in the literature is that of Bloom et al.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> which distinguishes between 3 histological varieties: non specific adenocarcinoma (45%), cystic adenoid carcinoma (30%) and mucoepidermoid carcinoma (15%). Of all of these, adenocarcinoma is most inclined to metastasize and has the poorest survival rate,<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> and its most frequent location is in the supraglottis.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Due to its infrequency, no scientifically endorsed therapy protocol exists and we only have retrospective studies at our disposal. In published cases, it has always been possible to carry out local and regional surgery. Several authors such as Mendelhall et al.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> also propose post-surgical radiotherapy, above all prior to the existence of adverse factors or in the case of regional metastasis in advanced tumours.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of Interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Clinical Case" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Discussion" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflicts of Interest" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-07-14" "fechaAceptado" => "2015-08-04" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Aguilar F, García DB, Crego F, Serrano Á. Adenocarcinoma de laringe con metástasis en el pene. Acta Otorrinolaringol Esp. 2016;67:e25–e27.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 885 "Ancho" => 1500 "Tamanyo" => 190228 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Computed tomography. (B) Macroscopic imaging of the laryngeal tumour.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1051 "Ancho" => 1400 "Tamanyo" => 513849 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Microscopic imaging of the laryngeal tumour. 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Journal Information
Vol. 67. Issue 4.
Pages e25-e27 (July - August 2016)
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Vol. 67. Issue 4.
Pages e25-e27 (July - August 2016)
Case study
Laryngeal Adenocarcinoma With Metastasis in Penis
Adenocarcinoma de laringe con metástasis en el pene
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