Sarcomatoid carcinoma of the pyriform sinus with brain and subcutaneous metastases: an unusual metastatic spread pattern

A 63-year-old man presented a polypoid tumor in the laryngeal space involvi ng the right pyriform fossa. The patient underwent a total laryngectomy wit h bilateral functional neck dissection, and the diagnosis of sarcomatoid ca rcinoma with malignant fibrous histiocytoma-like stroma was established. Th e tumor showed an uncommon behavior, with distant metastases to the brain a nd to the subcutaneous tissue of the abdominal wall. The patient died 1 yea r after the development of the metastases. Despite its polypoid pattern of growth, sarcomatoid carcinoma of the larynx may behave very aggressively. I t is important for clinicians to be aware of the possibility of distant sub cutaneous and brain metastases in sarcomatoid tumors of the laryngeal space . If such metastases develop, the prognosis is ominous, with an average lif e expectancy of 3 months.