POSTOPERATIVE SEEDING OF LARYNGEAL SQUAMOUS CELL CARCINOMA: A CASE REPORT

Abstract

Introduction: Surgical manipulation of malignant tumors can lead to the detachment of cancer cells and their dissemination into the surrounding interstitial fluid, vasculature, or along the tract of biopsy needles, potentially resulting in implantation and secondary tumor growth, also known as tumor seeding. Although squamous cell carcinoma (SCC) is among the most prevalent malignancies of the head and neck region, reported cases of tumor seeding in SCC of the larynx remain exceedingly rare. Nevertheless, this possibility should be continually considered to mitigate adverse outcomes and further enhance the safety and effectiveness of surgical interventions. 
Case presentation: A 68-year-old male patient was diagnosed with squamous cell carcinoma (SCC) of the left vocal cord and subsequently underwent left-sided cordectomy. Due to positive surgical margins on histopathological examination, adjuvant radiotherapy was administered, achieving clinical remission as confirmed by direct laryngoscopy and multislice spiral computed tomography (MSCT) scans. However, three months post-radiotherapy, a small tumor mass was clinically identified at the laryngofissure incision site and was confirmed histologically as SCC. No intralaryngeal lesions or other locoregional pathology 
were detected on further evaluation. The lesion was interpreted as postoperative tumor seeding and was surgically excised, with no evidence of recurrence during one year of follow up. 
Conclusion: Laryngeal squamous cell carcinoma possesses the potential for postoperative seeding, underscoring the importance of adhering to fundamental oncologic surgical principles. Additionally, the role of prophylactic measures against tumor seeding, and the exploration of the tumor microenvironment that facilitates such dissemination, merit further investigation.