Adenoid cystic carcinoma of the larynx.

Adenoid cystic carcinoma, or cylindromas, constitute a large and distinct group of neoplasms with characteristic microscopic features recognizable in tissues as varied as the nasal passages, tongue, and bronchi. Cylindromas of the larynx are rare and only 60 cases have been reported in a review of the literature in 1977. In this report, a case of adenoid cystic carcinoma originating in the subglottic area of the larynx is discussed, with emphasis on the clinical and pathologic characteristics. In the past, the histogenesis of cylindroma has been the subject of considerable controversy, but recent light microscopic and ultrastructural studies strongly implicate the seromucinous glands of the respiratory and upper digestive tracts as the tissues from which these neoplasms derive. In general, cylindromas of the upper alimentary and respiratory passages are best treated by wide surgical excision. Some clinicians have combined surgery with postoperative radiation therapy in an attempt to prevent or delay recurrence and metastases. Chemotherapeutic agents have also been employed in the postoperative management of adenoid cystic carcinoma although the longterm results of this treatment modality remain to be determined.