Localized laryngeal amyloidosis

A 54-year-old female schoolteacher presented with 1-month of hoarseness and a foreign body sensation in the back of her throat that was not associated with symptoms or signs of infection. Direct laryngoscopy showed bilateral, yellow, hyperemic masses on the false vocal folds and laryngeal ventricles Fig 1. Both true vocal folds were mobile. An excisional biopsy of the mass revealed an amorphous, eosinophilic hyaline material Fig 2 that exhibited apple-green birefringence when stained with Congo red and viewed under polarized light Fig 3, consistent with amyloidosis. There was no evidence of neoplasm. The work-up for systemic amyloidosis and multiple myeloma was negative. The patient did well over the next several years, but recurrence of the laryngeal amyloid tumor necessitated 2 additional conservative endoscopic CO2 laser excisions. Since her last surgery, the patient has remained asymptomatic.