Laryngeal Melanosis: Case Report and Review of the Literature

Introduction: Laryngeal melanosis (LM) is an unusual condition, defined by the presence of melanocytes within the laryngeal epithelial lining. Only 27 cases were reported in English literature and all of the patients were smokers.

Objectives: To present a case with laryngeal melanosis and discuss the clinical significance of this condition.

Resumed Report: A 52-year-old man, dark-skinned, rural worker, presented to our center with a history of globus sensation. In oroscopy, had hyperpigmented lesions on the buccal mucosa. Videolaryngoscopy revealed black-colored areas on ventricular bands, laryngeal surface of the epiglottis and aryepiglottic folds, in addition to posterior laryngeal edema. Patient was treated with proton pump inhibitor, obtaining partial improvement of symptoms and persistence of laryngoscopic findings. The patient underwent direct microlaryngoscopy, with biopsies of several fragments of the affected areas, which resulted in laryngeal melanosis. Patient was instructed about the disease and the possibility of head and neck cancer, but our study showed no suspicious lesion. He denied smoking and reported occupational exposure to inhalable pesticide and was instructed to use protective equipment. The patient remains in clinical monitoring.

Conclusion: The reported case contradicts the association between tobacco and laryngeal melanosis. The patient reported occupational exposure to inhalable pesticide. This association is not described in the literature, but there is an associative relationship between local chronic inflammation and increased pigment production. Physicians should be concerned about the possible association with head and neck cancer and perform a thorough evaluation for concomitant carcinoma.

Keywords: laryngeal melanosis, mucosal melanosis, larynx, melanosis.