Abstract
BACKGROUND: Squamous cell carcinoma accounts for up to 95% of malignant laryngeal tumors, whereas leiomyosarcoma is exceptionally rare, with fewer than 50 cases reported worldwide. The synchronous occurrence of two histogenetically distinct malignancies in the larynx is extremely uncommon and represents a diagnostic and therapeutic challenge. CASE PRESENTATION: We describe a 66-year-old Caucasian male with synchronous laryngeal tumors: a well-differentiated squamous cell carcinoma of the right vocal fold and a high-grade leiomyosarcoma of the subglottic region. Diagnosis was established using endoscopy, histopathology, and immunohistochemistry. The patient underwent total laryngectomy with permanent tracheostomy followed by adjuvant radiotherapy. At follow-up, no recurrence or progression was detected. CONCLUSION: This case illustrates the rare coexistence of epithelial and mesenchymal malignancies in the larynx and emphasizes the importance of multimodal diagnostic evaluation to guide optimal surgical management.