Squamous cell carcinoma of larynx

There is a gray-white lesion with granular texture in the right supraglottic region without midline  involvement (left).  There are nests of malignant cells invading into the submucosa (right). This lesion represents a microinvasive SCC, which have developed from carcinoma in situ.

 

The laryngeal SCC most commonly occurs in the supraglottic and glottic region. However, it can also occur in the pyriform sinus, posterior pharyngeal wall, and the trachea. Etiology includes tobacco use and alcohol abuse. The clinical presentation varies with the location of the lesion. Patients with supraglottic mass present with dysphonia, odynophagia, dysphagia, hemoptysis. Those with subglottic mass will often complain of dyspnea and airway obstruction. Similarly, respiratory symptoms worsen with lesions in the trachea. The diagnosis and treatment of SCC begins with clinical staging. Early stage tumors can be managed with surgical resection and/or radiotherapy. More advanced tumors require total laryngectomy with or without bilateral neck dissection. However, recent advances in surgical technique allow for organ-preserving options such as open partial laryngectomy or endoscopic transoral resection. Furthermore, concurrent chemotherapy and radiotherapy have shown promising results in the management of advanced laryngeal cancer. Nonetheless, it is important to tailor the treatment to each patient by discussing all available options – both surgical and non-surgical therapy.