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One Hundred Cases of Localized Laryngeal Amyloidosis - Evidence for Future Management

Harris, G; Lachmann, H; Hawkins, P; Sandhu, G; (2021) One Hundred Cases of Localized Laryngeal Amyloidosis - Evidence for Future Management. The Laryngoscope , 131 (6) E1912-E1917. 10.1002/lary.29320. Green open access

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Abstract

Objective/Hypothesis: To update the current understanding of localized laryngeal amyloidosis by analyzing the NHS National Amyloidosis Database and to further clarify the important ongoing management issues. Study Design: Retrospective review, case series. Methods: Patients with laryngeal amyloid were identified from the database of the NHS National Amyloidosis Center, UCL, Royal Free Hospital, London between 2000 and 2017. Patient demographics and disease profile were collated, including the exact location of amyloid deposit, treatments if any, and progression of disease. Results: One hundred and three patients with localized laryngeal amyloid where identified from the database, with a mean age of 54 at diagnosis and female to male ratio of 54:49. Three patients were excluded from further analysis due to limited database information. The majority of amyloid was found in either the supraglottis (44) or glottis (53) but all the laryngeal subsites were involved. One-third of the patients (34) had amyloid in more than one laryngeal subsite. No patients were found to progress to systemic amyloid, but many progressed locally to other subsites or further down the LTB tree (29%). Three patients were successfully treated with radiotherapy after other modalities had failed. Conclusions: This is the largest case series reported to date of localized laryngeal amyloidosis. It highlights the high incidence of multifocal disease and the significant proportion of patients who progressed, not to systemic amyloidosis but to more extensive localized amyloid. We recommend that in all cases of laryngeal amyloid, patients should undergo a thorough assessment of the upper and lower airways and have ongoing surveillance for at least 15 years.

Type: Article
Title: One Hundred Cases of Localized Laryngeal Amyloidosis - Evidence for Future Management
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/lary.29320
Publisher version: http://dx.doi.org/10.1002/lary.29320
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Amyloidosis, laryngeal amyloid, laryngotracheobronchial amyloid, larynx, EXTERNAL-BEAM RADIATION, TRACHEOBRONCHIAL AMYLOIDOSIS, EXPERIENCE, DIAGNOSIS, SERIES
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
URI: https://discovery.ucl.ac.uk/id/eprint/10131000
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