Pleomorphic Hyalinizing Angiectatic Tumor of the Larynx.

Pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare, benign soft tissue tumor with uncertain pathogenesis and lineage most commonly found in the lower and upper extremities. No reports exist of this tumor metastasizing, though local recurrence is common. To date, only approximately 100 cases have been reported. We present the case of a patient presenting with hoarseness and dyspnea found to have PHAT of the larynx, a location previously unreported in the literature and requiring unique management considerations.

Ultrasonic Pin Placement for Resorbable Rigid Fixation of a Thyroid Cartilage Fracture.

OBJECTIVE: To present the first use of an ultrasonic pin resorbable plate fixation system for rigid fixation of a laryngeal fracture. METHODS: Presentation of a 20-year-old male with a high velocity injury to his neck, via a lacrosse ball, resulting in a displaced laryngeal cartilage fracture. RESULTS: Intraoperatively, a Poly-D, L-Lactic Acid (PDLLA) polymer plate was contoured in-situ, bridging the fracture, and secured with ultrasonically placed resorbable pins. He was extubated on post-op day one and had return to vocal baseline one-month post-op. CONCLUSION: Ultrasonic pin placement systems for resorbable rigid fixation of a thyroid cartilage fracture optimizes recovery of respiratory and phonatory functions. Laryngoscope, 133:1470-1472, 2023.

Malignant Transformation in Glottic Dysplasia Treated With Photoangiolytic LASER - A Systematic Review and Meta-analysis.

OBJECTIVE: This systematic review and meta-analysis seeks to characterize the rate of malignant progression among patients with laryngeal dysplasia treated with photoangiolytic laser and compare to prior systematic reviews of conventional surgical approaches. METHODS: OVIDMedline, Pubmed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Google Scholar were searched, including terms related to patients with vocal fold dysplasia who were treated by angiolytic laser ablation. Some articles already known to authors or identified through hand searching were included. RESULTS: Six articles with 155 cases were included. Two studies used potassium titanyl phosphate exclusively, one solely used the pulsed dye laser, and three studies utilized both laser types during the study period. The pooled overall mean of malignant progression for patients with laryngeal dysplasia treated with photoangiolytic laser was 12%, as calculated by conducting a meta-analysis of single arm proportion. CONCLUSION: Laryngeal dysplasia is a premalignant lesion which confers a risk of progression to malignancy. After biopsy to establish the diagnosis there are multiple surgical techniques available for treatment with the goal of lesion eradication and voice preservation. In our review, there is a low malignant transformation rate for patients treated via with photoangiolytic laser.

DNA hypomethylation promotes transposable element expression and activation of immune signaling in renal cell cancer.

Recently, we reported that expression of endogenous retroviruses (ERVs) is associated with response to immune checkpoint blockade (ICB) in renal cell carcinoma (RCC). We show that decitabine, a DNA hypomethylating agent, activates transposable element (TE) expression (LINE1 and ERVs ERV3-2 and ERV4700) and antiviral signaling to potentially enhance response to ICB in kidney cancer cell lines and primary cells. KO of RIGI and MDA5 dsRNA sensors attenuated activation of antiviral signaling associated with DNA hypomethylation, and RIGI and MDA5 IPs showed increased ERV binding with decitabine treatment. Bioinformatic analyses showed the decitabine-induced signature could be associated with increased immune infiltration and response to ICB. Cytokine secretion induced by decitabine could modestly improve T cell activation and robustly enhanced T cell migration. In a small retrospective cohort of metastatic clear cell RCC (ccRCC) patients treated with anti-PD1/PDL1 blockade, activation of some antiviral genes was significantly higher in responders. Thus, we identified a potential strategy to induce TE expression through inhibition of DNA methylation in modulating T cell action via regulation of the innate antiviral pathway.