About larynx cancer

Chondrosarcoma of the larynx

Chondrosarcoma of the larynx accounts for approximately 0.2% of all head and neck malignancies and approximately 1% of all laryngeal malignant tumors, although it is the most common nonepithelial neoplasm of the larynx. Men are affected more frequently than women (3:1 ratio), usually during the middle to later decades of life. These tumors do not seem to be related to smoking or alcohol intake and in general arise spontaneously. Patients present with a variety of symptoms as a result of tumor growth, including dyspnea, dysphagia, hoarseness, airway obstruction, and/or pain.

Endoscopic findings may be a vocal cord paralysis that is not associated with any other laryngeal lesion or damage to the recurrent laryngeal nerve. Other findings include a submucosal mass typically located in the posterolateral subglottic region.

CT scan of the neck with contrast is the best diagnostic imaging study to be performed. In general, laryngeal chondrosarcoma appears as a lesion with calcified areas extensively involving one or more cartilages. Often seen is the displacement of surrounding structures rather than invasion, secondary to the slow growing nature of this tumor.

Histologically, chondrosarcoma can be classified as grade 1, grade 2, or grade 3. Ninety-five percent of tumors are of low grade nature.

Surgical excision is the treatment of choice. The tumor should be excised widely with special attention to excision of the external perichondrium. Since the tumor is not locally aggressive, conservative voice preserving procedures are preferred. Total laryngectomy should be performed only for lesions involving greater than 50% of the cricoid. Radiation and chemotherapy have not proven to be beneficial in cases of primary disease.