AN UNUSUAL ASSOCIATION OF LARYNGEAL RHINOSPORIDIOSIS WITH SQUAMOUS CELL CARCINOMA: A CASE REPORT

Dr. Shristi Butta*, Dr. Mallika Pal and Dr. Susmita Mukhopadhaya

ABSTRACT

Background: Rhinosporidiosis is a chronic disease caused by Rhinosporidium seeberi which mainly affects the nose and nasopharynx but cases have been reported in conjunctiva, skin, vulva, vagina, scalp and larynx. Larynx is comparatively a very rare site for its occurrence with only 7 cases reported till date in the world literature. Further, the association of rhinosporidiosis with squamous cell carcinoma is even rarer with very few cases reported previously. A 55year old male patient came to us with an enlarged cervical lymph node and a complaint of dysphagia with hoarseness of voice for last 6 months. Methods: The fine needle aspiration cytology (FNAC) was done from the enlarged cervical lymph node. 1. Chest radiography and computerized tomographic scan of the thorax. 2. Direct laryngoscopic biopsy. Results: FNAC was suggestive of a metastatic deposit from squamous cell carcinoma. Imaging, however, did not reveal any abnormality but as his dysphagia was getting even worse, the clinician planned a direct laryngoscopic biopsy, the histopathological examination of which yielded presence of rhinosporidiosis with few dysplastic squamous cells in the lining epithelia. Subsequent biopsy showed a histological evidence of a moderately differentiated squamous cell carcinoma along with rhinosporidiosis. Conclusion: This association of squamous cell carcinoma with rhinosporidiosis is rare with very few cases reported earlier. Further, laryngeal rhinosporidiosis is also a rare entity. Although clinically it presents as a reddish, polyploidal mass with a strawberry-like appearance, in cases occurring at unusual sites, histopathology remains the mainstay of diagnosis. Further, in every case of dysphagia it is very important to rule out laryngeal rhinosporidiosis as it has a potential risk of bleeding and aspiration causing life threatening complications.

Keywords: rhinosporidiosis, larynx, squamous cell carcinoma.