Primary intestinal-type adenocarcinoma of the larynx: A case report and literature review.

Primary intestinal-type adenocarcinoma (ITAC) of the larynx is extremely rare and requires differentiation from metastatic intestinal adenocarcinoma due to their similar morphological and immunophenotypic features. This case report describes a man in his early 70s presenting with 3 months of hoarseness, with a history of well-controlled coronary heart disease and hypertension. Laryngoscopy revealed nodular masses in the anterior part of the left ventricular fold and epiglottic tubercle, while neck ultrasound demonstrated no significantly enlarged lymph nodes. The patient underwent extended resection of the mass via transoral CO laser microsurgery, with negative surgical margins. Postoperative pathology combined with immunohistochemistry (CK7 -, CK20 +, CDX2 +, SATB2 +, Villin +) confirmed the diagnosis. Gastrointestinal endoscopy ruled out metastatic lesions, and whole-body PET/CT showed no abnormal involvement. No tumor recurrence was observed during 12 months of follow up. This case emphasizes the importance of pathology, gastrointestinal endoscopy, and imaging in differentiating primary from metastatic lesions in laryngeal adenocarcinoma with intestinal differentiation. Surgical resection is the preferred treatment for early localized lesions, and additional long-term follow-up data are required to clarify the prognosis.