Radiation-Induced Leiomyosarcoma of the Larynx: A Case Report and Literature Review

Leiomyosarcomas are rare malignant tumors arising from smooth muscle cells and may develop in various anatomical locations. Laryngeal involvement is exceptionally rare, accounting for less than 1% of malignant laryngeal tumors, particularly in a post-radiotherapy context. We report the case of a 75-year-old patient treated in 2005 for an undifferentiated carcinoma of the nasopharynx with induction chemotherapy followed by concomitant chemoradiotherapy. Seventeen years after the initial treatment, the patient presented with chronic cervical pain associated with dysphonia. Nasofibroscopy and cervico-thoracic imaging revealed a supraglottic tumoral process. Histopathological examination combined with immunohistochemical analysis confirmed the diagnosis of laryngeal leiomyosarcoma. The patient underwent total laryngectomy followed by adjuvant radiotherapy at a dose of 60 Gy. A favorable clinical and radiological outcome was observed for two years, after which pulmonary recurrence occurred. Laryngeal leiomyosarcoma is an exceptionally rare entity, often associated with a poor prognosis. Its late occurrence after radiotherapy, as illustrated in our case, highlights the importance of prolonged clinical follow-up in irradiated patients.