Differing characteristics of cartilaginous lesions of the larynx

Eur Arch Otorhinolaryngol. 2019 Oct;276(10):2635-2647. doi: 10.1007/s00405-019-05563-w. Epub 2019 Jul 23.

Abstract

Introduction: The tissues of the laryngeal region only rarely harbor primary cartilaginous lesions, and squamous cell carcinoma remains the most frequently encountered malignant tumor in this area.

Materials and methods: We reviewed the salient histological features of cartilaginous laryngeal lesions to provide differential diagnostics and guidelines for distinguishing the benign from the malignant ones.

Results: Cartilaginous neoplasms of the larynx include chondroma and chondrosarcoma. Among the overarching group of all forms of laryngeal sarcoma, chondrosarcoma forms the most common entity in the larynx, followed by rhabdomyosarcoma. Cartilaginous tumors comprise about 0.1%-1% of all laryngeal neoplasms with chondrosarcomas being more frequently encountered than chondromas. Several neoplasms earlier reported as giant-cell tumors of the larynx would most likely, using current terminology, be classified as cases of undifferentiated pleomorphic sarcoma (previously known as malignant fibrous histiocytoma, giant-cell variant) or aneurysmal bone cyst.

Conclusion: When true laryngeal sarcomas do exist, they may prove to be challenging lesions both for the pathologist and the treating clinician. The diagnostic problems are mainly a result of the infrequent exposure of clinicians and diagnosticians to these lesions.

Keywords: Histology; Metastasis; Pathology; Radiotherapy; Surgery.

MeSH terms

  • Biopsy / methods
  • Bone Neoplasms / diagnosis
  • Carcinoma, Squamous Cell / diagnosis*
  • Chondroma* / diagnosis
  • Chondroma* / pathology
  • Chondroma* / therapy
  • Chondrosarcoma* / diagnosis
  • Chondrosarcoma* / pathology
  • Diagnosis, Differential
  • Female
  • Humans
  • Laryngeal Cartilages / pathology*
  • Laryngeal Neoplasms* / classification
  • Laryngeal Neoplasms* / diagnosis
  • Laryngeal Neoplasms* / pathology
  • Laryngeal Neoplasms* / therapy
  • Male
  • Middle Aged
  • Otorhinolaryngologic Surgical Procedures / methods
  • Prognosis
  • Soft Tissue Neoplasms* / diagnosis
  • Soft Tissue Neoplasms* / pathology
  • Soft Tissue Neoplasms* / therapy