Bilateral Vocal Cord Carcinoma in a Sarcoidosis Patient during Infliximab Therapy

Introduction. Although the role of TNF-α in tumor development is not fully understood, an increased risk of malignancy with TNF-α-inhibitors, such as infliximab, has been suggested. Case Presentation. We present a 54-year-old nonsmoking female sarcoidosis patient. After seven months of infliximab th...

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Main Authors: Adriane D. M. Vorselaars, Elisabeth V. Sjögren, Coline H. M. van Moorsel, Jan C. Grutters
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Pulmonology
Online Access:http://dx.doi.org/10.1155/2013/308092
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author Adriane D. M. Vorselaars
Elisabeth V. Sjögren
Coline H. M. van Moorsel
Jan C. Grutters
author_facet Adriane D. M. Vorselaars
Elisabeth V. Sjögren
Coline H. M. van Moorsel
Jan C. Grutters
author_sort Adriane D. M. Vorselaars
collection DOAJ
description Introduction. Although the role of TNF-α in tumor development is not fully understood, an increased risk of malignancy with TNF-α-inhibitors, such as infliximab, has been suggested. Case Presentation. We present a 54-year-old nonsmoking female sarcoidosis patient. After seven months of infliximab therapy a T1aN0M0 larynx carcinoma of the right vocal cord was found and excised. Within a year, whilst still on treatment, a second larynx carcinoma of the opposite vocal cord appeared. Discussion. A bilateral vocal cord tumor is rare, especially in a never smoker. Evidence on the role of infliximab in carcinogenesis is inconclusive. To date, there are no follow-up studies evaluating malignancy risk of infliximab therapy in sarcoidosis patients. No studies in other diseases focus on laryngeal carcinomas during infliximab use. We argue that infliximab treatment might have attributed to the rapid progression of vocal cord carcinomas in this patient with an a priori low risk tumor profile. This case illustrates that caution remains warranted in patients with previous malignancies when considering initiation of TNF-α-inhibitors.
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spelling doaj-art-53f78cc67cef4edb8e9c8d47aa54c66a2025-08-20T03:36:25ZengWileyCase Reports in Pulmonology2090-68462090-68542013-01-01201310.1155/2013/308092308092Bilateral Vocal Cord Carcinoma in a Sarcoidosis Patient during Infliximab TherapyAdriane D. M. Vorselaars0Elisabeth V. Sjögren1Coline H. M. van Moorsel2Jan C. Grutters3Centre of Interstitial Lung Diseases, Department of Pulmonology, St. Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, The NetherlandsDepartment of Otolaryngology, Head & Neck Surgery, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The NetherlandsCentre of Interstitial Lung Diseases, Department of Pulmonology, St. Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, The NetherlandsCentre of Interstitial Lung Diseases, Department of Pulmonology, St. Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, The NetherlandsIntroduction. Although the role of TNF-α in tumor development is not fully understood, an increased risk of malignancy with TNF-α-inhibitors, such as infliximab, has been suggested. Case Presentation. We present a 54-year-old nonsmoking female sarcoidosis patient. After seven months of infliximab therapy a T1aN0M0 larynx carcinoma of the right vocal cord was found and excised. Within a year, whilst still on treatment, a second larynx carcinoma of the opposite vocal cord appeared. Discussion. A bilateral vocal cord tumor is rare, especially in a never smoker. Evidence on the role of infliximab in carcinogenesis is inconclusive. To date, there are no follow-up studies evaluating malignancy risk of infliximab therapy in sarcoidosis patients. No studies in other diseases focus on laryngeal carcinomas during infliximab use. We argue that infliximab treatment might have attributed to the rapid progression of vocal cord carcinomas in this patient with an a priori low risk tumor profile. This case illustrates that caution remains warranted in patients with previous malignancies when considering initiation of TNF-α-inhibitors.http://dx.doi.org/10.1155/2013/308092
spellingShingle Adriane D. M. Vorselaars
Elisabeth V. Sjögren
Coline H. M. van Moorsel
Jan C. Grutters
Bilateral Vocal Cord Carcinoma in a Sarcoidosis Patient during Infliximab Therapy
Case Reports in Pulmonology
title Bilateral Vocal Cord Carcinoma in a Sarcoidosis Patient during Infliximab Therapy
title_full Bilateral Vocal Cord Carcinoma in a Sarcoidosis Patient during Infliximab Therapy
title_fullStr Bilateral Vocal Cord Carcinoma in a Sarcoidosis Patient during Infliximab Therapy
title_full_unstemmed Bilateral Vocal Cord Carcinoma in a Sarcoidosis Patient during Infliximab Therapy
title_short Bilateral Vocal Cord Carcinoma in a Sarcoidosis Patient during Infliximab Therapy
title_sort bilateral vocal cord carcinoma in a sarcoidosis patient during infliximab therapy
url http://dx.doi.org/10.1155/2013/308092
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AT colinehmvanmoorsel bilateralvocalcordcarcinomainasarcoidosispatientduringinfliximabtherapy
AT jancgrutters bilateralvocalcordcarcinomainasarcoidosispatientduringinfliximabtherapy