Transglottic laryngeal melanoma presented as severe dyspnea

Abstract

Introduction While mucosal melanoma of the head and neck remains an uncommon condition, its incidence has been on the rise in recent decades. Within the larynx, the supraglottis represents the most frequently affected subsite, followed by the glottis, with hoarseness being the predominant symptom. Given the tumor’s aggressive behavior and its challenging location, it is often overlooked until it progresses to an advanced stage, which significantly worsens the prognosis. Case report A 45-year-old male patient with stridorous breathing presented to the emergency room. An indirect laryngoscopy revealed a transglottic mass occupying the left piriform recess and the entire laryngeal inlet, leading to an exceptionally narrowed airway. Urgent tracheostomy was performed. Contrast-enhanced computed tomography of the neck identified an ulceroproliferative mass in the larynx, spanning the supraglottic, glottic, and subglottic regions, causing airway narrowing and extending into the left pyriform sinus. Laryngoscopy was performed, and biopsy of the laryngeal lesion confirmed a diagnosis of malignant melanoma. Unfortunately, the patient refused further surgical and oncological treatment, as well as additional diagnostic procedures. Four months after the initial diagnosis, the patient was lost to follow-up. Conclusion Laryngeal melanoma is an uncommon condition that can necessitate an emergency tracheostomy. Since melanoma can be mistaken for other laryngeal malignancies, immunohistochemical analysis plays a crucial role in making an accurate diagnosis. Early detection of the disease is vital. © 2025, Serbia Medical Society. All rights reserved.