Updated: May 2003
The majority of laryngeal tumours are squamous cell carcinomas. Rare tumours include minor salivary gland tumours, sarcoma and plasmacytoma.
Hyperkeratosis of the Vocal Cords
Hyperkeratosis of the vocal cords should be viewed with caution and all of these patients should have repeat microlaryngoscopy and excision if any abnormality persists.
Biopsy reports may be misleading because of sampling error. Many dysplastic lesions progress to malignancy.
All involved physicians must be aware of the high incidence of multicentric lesions and of co-existing invasive carcinoma in the larynx of these patients. Surgery usually involves stripping the cord or CO2 laser excision.
Radiotherapy is indicated for bilateral in situ disease or disease that recurs after adequate surgical treatment.
Squamous Cell Carcinoma of the Larynx
Early lesions T1 T2
Primary treatment is by radiation therapy. Partial or total laryngectomy is reserved for persistent or recurrent disease, although it may be an option in selected cases as a primary treatment.
Locally advanced T3 T4
These patients often require a combination of a planned course of radiation and surgery. Many patients may be curable by radiation or surgery alone and selection of the treatment modality in each patient will require a multidisciplinary assessment.
Nodal metastatic disease is common in all but cancers confined to the true vocal cords. A small single node located within the radiation field may be cured by radiation alone, but larger or multiple nodes will require a neck dissection.
Surgery for persistent or recurrent disease will require radical resection of the primary and neck dissection.