Recurrent Laryngeal Neurofibroma Unrelated to NF Type 1

Abstract

Objective: Although rare, neurofibromas arising from the recurrent laryngeal nerve in neurofibromatosis type I patients have been cited in the literature. However, recurrent laryngeal neurofibromas unrelated to this inherited disorder have not been reported. We describe a new entity of a recurrent laryngeal neurofibroma arising at the level of the glottis.

Method: A case report and literature review is presented. A patient with progressive dysphonia, dysphagia, and mild dyspnea was referred to our cancer center in November 2011 for assessment. Flexible laryngoscopy revealed right vocal cord paresis and a submucosal mass causing medial displacement of the right arytenoid.

Results: CT imaging revealed a well-defined, nonenhancing mass at the level of the posterior glottis. Transoral endoscopic surgical excision of the mass was performed. Pathology revealed a benign peripheral nerve sheath tumor consistent with a neurofibroma. The patient had resolution of his dyspnea and achieved significant improvement of his voice with a 6-week course of speech therapy, despite postoperative right vocal cord paralysis.

Conclusion: Isolated neurofibromas of the recurrent laryngeal nerve, without the appearance of other characteristic features of von Recklinhausen disease have not been reported. Although benign, early recognition and surgical excision of these lesions is necessary to prevent airway obstruction, dysphagia, and aspiration.