Secondarism to the larynx represents a very rare finding, and metastasis from lung adenocarcinoma is an even rarer event [1, 2]. International Literature describes malignant melanoma as the main secondarism affecting the larynx directly followed by renal cell carcinoma. Being an almost fully cartilaginous and muscular anatomical structure justifies the rarity of metastatic spread to the larynx from distant organs. Due to his cephalic position larynx benefits from the terminal vascular and lymphatic supply [5]. Ferlito et al. (1993) described 134 cases of secondarsim to the larynx, appointing only 9 patients suffering from bronchogenic or lung metastasis (12,06%) [4]. After 1993 only 4 other cases of bronchogenic spread to the larynx have been described, showing the rarity of this particular biological spread. The brief review of literature provided here has the goal to present 4 cases of bronchogenic and lung malignancies that affected the larynx. Exclusion criteria were inherent to the language of the manuscript, as we accounted for only publications in English.

The first case (Kalai et al., 2015) described a 49 years old male patient suffering from shortness of breath and loss of weight, diagnosed with a lung tumor that showed a small nodule on the inferior surface of the epiglottis. Despite the Histopathological diagnosis of squamous cell carcinoma, the laryngeal metastasis, being asymptomatic, was not directly treated. The treatment was based on platinum‑based doublet chemotherapy (Paclitaxel with Cisplatin) [5].

Excluded this particular case, the other three publications included in this review share some typical aspects, both from the clinical and surgical point of view: Bernaldez et al. (1994) described a 56 years old male with a known history of epidermoid carcinoma of the left lung underwent total laryngectomy with left radical neck dissection and right functional neck dissection for a 2 × 2 cm polypoid lesion in the left aryepiglottic fold [1].

Nicolai et al. (1996) described a 69-year-old patient with dysphonia due to a transglottic mass with partial destruction of the cricoid cartilage. At the same time, an additional lesion in the apical lobe of the right lung was discovered. Histopathological examination of both lesions showed poorly differentiated adenocarcinoma. The patient finally underwent a total laryngectomy extended to the first two tracheal rings, bilateral functional neck dissection, and total thyroidectomy after the failure of radiotherapy [3].

Ogata et al. (1993) described a 59-year female with a history of adenocarcinoma of the lower lung treated with lobectomy. The patient suffered from a 5 mm hemangioma-like lesion with a smooth surface beneath the anterior commissure of the larynx. Histopathological examination confirmed the diagnosis of adenocarcinoma and she finally underwent a partial laryngectomy [6] (Table 1).

Of the 4 case reports, only Kalai et al. did not describe a patient whose main symptom was related to phonation. This was the only patient in the review who did not benefit from any surgical treatment, as the laryngeal metastasis was asymptomatic. This example carries the first possible indication to justify the surgical treatment of this kind of lesion, that is the clinical behavior of the mass. International literature agrees on another fundamental parameter to justify partial or total laryngectomy, whereas the tumor represents a single metastasis and other organs had not been affected [1, 4, 6, 7] The CT and PET-CT scans of the patient presented in this.

manuscript showed no other secondarism except for the right hemilarynx and a right laterocervical mass, leading to the decision of performing at first right hemilaryngeal biopsy.

Once got the histopathological diagnosis supraglottic laryngectomy with prophylactic functional right and left neck dissection was performed. As the prognosis of this kind of patients is often unfortunate depending on the lymphatic vessels spread through the body, post-operative chemotherapy assumes an even more important role in the management of the lung secondarism to the larynx [10].