Vascular leiomyoma of the larynx: a rare entity. Three case reports and literature review

Background: We conducted a review of the literature to investigate the clinical presentations and histopathologic findings of laryngeal vascular leiomyomas.

Method: We retrospectively analyzed 24 cases of vascular leiomyomas of the larynx.

Results: Vascular leiomyoma of the larynx is a very uncommon tumor with only 24 cases reported in the literature. Of the 24 cases, the male/female ratio was 19/5. The patients were from 11 to 78 years old, and nearly half of the patients (11/24) were between the ages of 40 and 60. The tumor occurrence sites varied, with the supraglottic region being most common (14/24), followed by the glottic region (7/24) and the subglottic region (3/24). A common symptom of laryngeal leiomyoma is hoarseness of voice. The tumor is submucosal with dilated vessels on the surface. Histopathologically, the tumor cells are composed of numerous variform blood vessels lacking mitosis and well-differentiated smooth muscle bundles. Complete surgical excision is the most commonly recommended treatment.

Conclusions: Vascular leiomyoma is a benign tumor. External incision effectively prevents hemorrhage during the operation and recurrence after the operation. A smaller, well-circumscribed laryngeal vascular leiomyoma may be easily amenable to transoral laser resection. Preoperative embolization can be potentially used to benefit the laryngeal transoral resection.