Laryngeal Tumors

Question 1

Conventional squamous cell carcinoma of the larynx

Answer 1

• 90% of all laryngeal cancers
• 96% male
• Risk factors: Smoking, alcohol consumption is effect modifier
• HPV is not an early factor, but is present in 20% of cases

Question 2

Laryngeal papilloma

Answer 2

Progresses to SCC in 4% of cases

Caused by HPV 6 or 11 infection of the true vocal cord.

Cauliflower-like HPV appearance on gross anatomy. Typical HPV-related squamous changes on histology.

Question 3

Vocal fold granuloma

Answer 3

Lesion spanning both vocal cords most often caused by intubation trauma with subsequent inflammation and ulceration

Can present with atypical GERD symptoms (hoarseness of voice, cough) due to reflux of acid through to the larynx.

Question 4

Classification of laryngeal squamous cell carcinomas

Answer 4

Classified by relation to tongue

• Glottic / true vocal cord (most common, best prognosis)
• Supraglotic (good prognosis)
• Subglotic (least common, worst prognosis)

Question 5

Laryngeal carcinoma is basically always going to be ___

Answer 5

Laryngeal cancer is basically always going to be SCC

Question 6

Leukoplakia

Answer 6

Premalignant lesion in mucosal sites. Not to be confused with oral hairy leukoplakia, which is indicative of HIV/EBV coinfection.

Defined as hyperkeratosis of epithelia and mucous membranes. Most commonly oropharyngeal and related to smoking/alcohol.

Should be biopsied to check for dysplasia. Histology shows hyperkeratosis, parakeratosis, acanthosis, or may simply show atrophy. Low-grade dysplasia is not uncommonly present. Some may show foci of squamous cell carcinoma.

Treat with smoking cessation and ablation (cryo, laser)

Question 7

Gross anatomy of leukoplakia

Answer 7