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Head and Neck
Diagnosis
Hypopharynx, Larynx, and Cervical Trachea
Benign and Malignant Tumors
Larynx Carcinoma
Larynx Carcinoma
Philip R. Chapman, MD
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9

OVERVIEW

  • General Comments

    • Classification

      PATHOLOGY

      • Routes of Spread

        • General Features

          • Gross Pathology & Surgical Features

            • Microscopic Features

              IMAGING FINDINGS

              • Detection

                • Staging

                  • Restaging

                    CLINICAL ISSUES

                    • Presentation

                      • Cancer Natural History & Prognosis

                        • Treatment Options

                          REPORTING CHECKLIST

                          • T Staging

                            • N Staging

                              • M Staging

                                Selected References

                                1. Becker M et al: MR imaging of laryngeal and hypopharyngeal cancer. Magn Reson Imaging Clin N Am. 30(1):53-72, 2022
                                2. Contrera KJ et al: Clinical versus pathologic laryngeal cancer staging and the impact of stage change on outcomes. Laryngoscope. 131(3):559-65, 2021
                                3. de Andrade NMM et al: Tumor volume as a prognostic factor of locally advanced laryngeal cancer. Eur Arch Otorhinolaryngol. 278(5):1627-35, 2021
                                4. Li MM et al: Stage migration and survival trends in laryngeal cancer. Ann Surg Oncol. 28(12):7300-9, 2021
                                5. Mattioli F et al: pT3 N0 laryngeal squamous cell carcinoma: oncologic outcomes and prognostic factors of surgically treated patients. Laryngoscope. 131(10):2262-8, 2021
                                6. Pakkanen P et al: T1 glottic laryngeal cancer: the role of routine follow-up visits in detecting local recurrence. Eur Arch Otorhinolaryngol. 278(12):4863-9, 2021
                                7. Glastonbury CM: Critical changes in the staging of head and neck cancer. Radiol Imaging Cancer. 2(1):e190022, 2020
                                8. Lucioni M et al: The thyro-cricoarytenoid space (TCAS): clinical and prognostic implications in laryngeal cancer. Acta Otorhinolaryngol Ital. 40(2):106-12, 2020
                                9. Del Bon F et al: Open partial horizontal laryngectomies for T3⁻T4 laryngeal cancer: prognostic impact of anterior vs. posterior laryngeal compartmentalization. Cancers (Basel). 11(3), 2019
                                10. Li M et al: Role of postoperative adjuvant radiotherapy for locally advanced laryngeal cancer: a meta-analysis. Acta Otolaryngol. 139(2):172-7, 2019
                                11. Obid R et al: The treatment of laryngeal cancer. Oral Maxillofac Surg Clin North Am. 31(1):1-11, 2019
                                12. Pan Y et al: Survival analysis of distant metastasis of laryngeal carcinoma: analysis based on SEER database. Eur Arch Otorhinolaryngol. 276(1):193-201, 2019
                                13. Yang D et al: Effect of HPV infection on the occurrence and development of laryngeal cancer: a review. J Cancer. 10(19):4455-62, 2019
                                14. Baird BJ et al: Treatment of early-stage laryngeal cancer: a comparison of treatment options. Oral Oncol. 87:8-16, 2018
                                15. Szyszko TA et al: PET/CT and PET/MRI in head and neck malignancy. Clin Radiol. 73(1):60-9, 2018
                                16. Amin MB et al: AJCC Cancer Staging Manual. 8th ed. New York: Springer, 2017
                                17. Brandstorp-Boesen J et al: Impact of stage, management and recurrence on survival rates in laryngeal cancer. PLoS One. 12(7):e0179371, 2017
                                18. Ding W et al: Supraglottic squamous cell carcinomas have distinctive clinical features and prognosis based on subregion. PLoS One. 12(11):e0188322, 2017
                                19. Duprez F et al: Distant metastases in head and neck cancer. Head Neck. 39(9):1733-43, 2017
                                20. Preda L et al: Diagnostic accuracy of surface coil MRI in assessing cartilaginous invasion in laryngeal tumours: Do we need contrast-agent administration? Eur Radiol. 27(11):4690-8, 2017
                                21. Marchiano E et al: Subglottic squamous cell carcinoma: a population-based study of 889 cases. Otolaryngol Head Neck Surg. 154(2):315-21, 2016
                                22. Kuno H et al: Primary staging of laryngeal and hypopharyngeal cancer: CT, MR imaging and dual-energy CT. Eur J Radiol. 83(1):e23-35, 2014
                                23. Tomeh C et al: Laryngeal cancer. Curr Opin Otolaryngol Head Neck Surg. 22(2):147-53, 2014
                                24. Baugnon KL et al: Pitfalls in the staging of cancer of the laryngeal squamous cell carcinoma. Neuroimaging Clin N Am. 23(1):81-105, 2013
                                25. Chen SA et al: Patterns of extralaryngeal spread of laryngeal cancer: thyroid cartilage penetration occurs in a minority of patients with extralaryngeal spread of laryngeal squamous cell cancers. Cancer. 117(22):5047-51, 2011
                                26. An SY et al: Surgical management of locally advanced thyroid cancer. Curr Opin Otolaryngol Head Neck Surg. 18(2):119-23, 2010
                                27. American Joint Committee on Cancer: AJCC Cancer Staging Manual. 7th ed. New York: Springer, 2010
                                28. Goudakos JK et al: Management of the clinically negative neck (N0) of supraglottic laryngeal carcinoma: a systematic review. Eur J Surg Oncol. 35(3):223-9, 2009
                                29. Gourin CG et al: A contemporary review of indications for primary surgical care of patients with squamous cell carcinoma of the head and neck. Laryngoscope. 119(11):2124-34, 2009
                                30. Guido A et al: Combined 18F-FDG-PET/CT imaging in radiotherapy target delineation for head-and-neck cancer. Int J Radiat Oncol Biol Phys. 73(3):759-63, 2009
                                31. Higgins KM et al: Treatment of early-stage glottic cancer: meta-analysis comparison of laser excision versus radiotherapy. J Otolaryngol Head Neck Surg. 38(6):603-12, 2009
                                32. McCoul ED et al: Meta-analysis of impaired vocal cord mobility as a prognostic factor in T2 glottic carcinoma. Arch Otolaryngol Head Neck Surg. 135(5):479-86, 2009
                                33. Becker M et al: Imaging of the larynx and hypopharynx. Eur J Radiol. 66(3):460-79, 2008
                                34. Blitz AM et al: Radiologic evaluation of larynx cancer. Otolaryngol Clin North Am. 41(4):697-713, vi, 2008
                                35. Chu EA et al: Laryngeal cancer: diagnosis and preoperative work-up. Otolaryngol Clin North Am. 41(4):673-95, v, 2008
                                36. Ferlito A et al: Selective neck dissection (IIA, III): a rational replacement for complete functional neck dissection in patients with N0 supraglottic and glottic squamous carcinoma. Laryngoscope. 118(4):676-9, 2008
                                37. Hristov B et al: Radiotherapeutic management of laryngeal carcinoma. Otolaryngol Clin North Am. 41(4):715-40, vi, 2008
                                38. Chong VF: Tumour volume measurement in head and neck cancer. Cancer Imaging. 7 Spec No A:S47-9, 2007
                                39. Connor S: Laryngeal cancer: how does the radiologist help? Cancer Imaging. 7:93-103, 2007
                                40. Mendenhall WM et al: Multidisciplinary management of laryngeal carcinoma. Int J Radiat Oncol Biol Phys. 69(2 Suppl):S12-4, 2007
                                41. Morton RP et al: Thyroid cancer invasion of neck structures: epidemiology, evaluation, staging and management. Curr Opin Otolaryngol Head Neck Surg. 15(2):89-94, 2007
                                42. Roh JL et al: 2-[18F]-Fluoro-2-deoxy-D-glucose positron emission tomography as guidance for primary treatment in patients with advanced-stage resectable squamous cell carcinoma of the larynx and hypopharynx. Eur J Surg Oncol. 33(6):790-5, 2007
                                43. Taguchi T et al: Concurrent chemoradiotherapy with carboplatin and uracil-ftegafur in patients with stage two (T2 N0 M0) squamous cell carcinoma of the glottic larynx. J Laryngol Otol. 120(6):478-81, 2006
                                44. Daisne JF et al: Tumor volume in pharyngolaryngeal squamous cell carcinoma: comparison at CT, MR imaging, and FDG PET and validation with surgical specimen. Radiology. 2004 Oct;233(1):93-100. Epub 2004 Aug 18. Erratum in: Radiology. 235(3):1086, 2005
                                45. Mendenhall WM et al: Management of T1-T2 glottic carcinomas. Cancer. 100(9):1786-92, 2004
                                46. Wax MK et al: The role of positron emission tomography in the evaluation of the N-positive neck. Otolaryngol Head Neck Surg. 129(3):163-7, 2003
                                47. Zinreich SJ: Imaging in laryngeal cancer: computed tomography, magnetic resonance imaging, positron emission tomography. Otolaryngol Clin North Am. 35(5):971-91, v, 2002
                                48. Ferlito A et al: Incidence and sites of distant metastases from head and neck cancer. ORL J Otorhinolaryngol Relat Spec. 63(4):202-7, 2001
                                49. Becker M: Neoplastic invasion of laryngeal cartilage: radiologic diagnosis and therapeutic implications. Eur J Radiol. 33(3):216-29, 2000
                                50. Reidenbach MM: The paraglottic space and transglottic cancer: anatomical considerations. Clin Anat. 9(4):244-51, 1996
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                OVERVIEW

                                • General Comments

                                  • Classification

                                    PATHOLOGY

                                    • Routes of Spread

                                      • General Features

                                        • Gross Pathology & Surgical Features

                                          • Microscopic Features

                                            IMAGING FINDINGS

                                            • Detection

                                              • Staging

                                                • Restaging

                                                  CLINICAL ISSUES

                                                  • Presentation

                                                    • Cancer Natural History & Prognosis

                                                      • Treatment Options

                                                        REPORTING CHECKLIST

                                                        • T Staging

                                                          • N Staging

                                                            • M Staging

                                                              Selected References

                                                              1. Becker M et al: MR imaging of laryngeal and hypopharyngeal cancer. Magn Reson Imaging Clin N Am. 30(1):53-72, 2022
                                                              2. Contrera KJ et al: Clinical versus pathologic laryngeal cancer staging and the impact of stage change on outcomes. Laryngoscope. 131(3):559-65, 2021
                                                              3. de Andrade NMM et al: Tumor volume as a prognostic factor of locally advanced laryngeal cancer. Eur Arch Otorhinolaryngol. 278(5):1627-35, 2021
                                                              4. Li MM et al: Stage migration and survival trends in laryngeal cancer. Ann Surg Oncol. 28(12):7300-9, 2021
                                                              5. Mattioli F et al: pT3 N0 laryngeal squamous cell carcinoma: oncologic outcomes and prognostic factors of surgically treated patients. Laryngoscope. 131(10):2262-8, 2021
                                                              6. Pakkanen P et al: T1 glottic laryngeal cancer: the role of routine follow-up visits in detecting local recurrence. Eur Arch Otorhinolaryngol. 278(12):4863-9, 2021
                                                              7. Glastonbury CM: Critical changes in the staging of head and neck cancer. Radiol Imaging Cancer. 2(1):e190022, 2020
                                                              8. Lucioni M et al: The thyro-cricoarytenoid space (TCAS): clinical and prognostic implications in laryngeal cancer. Acta Otorhinolaryngol Ital. 40(2):106-12, 2020
                                                              9. Del Bon F et al: Open partial horizontal laryngectomies for T3⁻T4 laryngeal cancer: prognostic impact of anterior vs. posterior laryngeal compartmentalization. Cancers (Basel). 11(3), 2019
                                                              10. Li M et al: Role of postoperative adjuvant radiotherapy for locally advanced laryngeal cancer: a meta-analysis. Acta Otolaryngol. 139(2):172-7, 2019
                                                              11. Obid R et al: The treatment of laryngeal cancer. Oral Maxillofac Surg Clin North Am. 31(1):1-11, 2019
                                                              12. Pan Y et al: Survival analysis of distant metastasis of laryngeal carcinoma: analysis based on SEER database. Eur Arch Otorhinolaryngol. 276(1):193-201, 2019
                                                              13. Yang D et al: Effect of HPV infection on the occurrence and development of laryngeal cancer: a review. J Cancer. 10(19):4455-62, 2019
                                                              14. Baird BJ et al: Treatment of early-stage laryngeal cancer: a comparison of treatment options. Oral Oncol. 87:8-16, 2018
                                                              15. Szyszko TA et al: PET/CT and PET/MRI in head and neck malignancy. Clin Radiol. 73(1):60-9, 2018
                                                              16. Amin MB et al: AJCC Cancer Staging Manual. 8th ed. New York: Springer, 2017
                                                              17. Brandstorp-Boesen J et al: Impact of stage, management and recurrence on survival rates in laryngeal cancer. PLoS One. 12(7):e0179371, 2017
                                                              18. Ding W et al: Supraglottic squamous cell carcinomas have distinctive clinical features and prognosis based on subregion. PLoS One. 12(11):e0188322, 2017
                                                              19. Duprez F et al: Distant metastases in head and neck cancer. Head Neck. 39(9):1733-43, 2017
                                                              20. Preda L et al: Diagnostic accuracy of surface coil MRI in assessing cartilaginous invasion in laryngeal tumours: Do we need contrast-agent administration? Eur Radiol. 27(11):4690-8, 2017
                                                              21. Marchiano E et al: Subglottic squamous cell carcinoma: a population-based study of 889 cases. Otolaryngol Head Neck Surg. 154(2):315-21, 2016
                                                              22. Kuno H et al: Primary staging of laryngeal and hypopharyngeal cancer: CT, MR imaging and dual-energy CT. Eur J Radiol. 83(1):e23-35, 2014
                                                              23. Tomeh C et al: Laryngeal cancer. Curr Opin Otolaryngol Head Neck Surg. 22(2):147-53, 2014
                                                              24. Baugnon KL et al: Pitfalls in the staging of cancer of the laryngeal squamous cell carcinoma. Neuroimaging Clin N Am. 23(1):81-105, 2013
                                                              25. Chen SA et al: Patterns of extralaryngeal spread of laryngeal cancer: thyroid cartilage penetration occurs in a minority of patients with extralaryngeal spread of laryngeal squamous cell cancers. Cancer. 117(22):5047-51, 2011
                                                              26. An SY et al: Surgical management of locally advanced thyroid cancer. Curr Opin Otolaryngol Head Neck Surg. 18(2):119-23, 2010
                                                              27. American Joint Committee on Cancer: AJCC Cancer Staging Manual. 7th ed. New York: Springer, 2010
                                                              28. Goudakos JK et al: Management of the clinically negative neck (N0) of supraglottic laryngeal carcinoma: a systematic review. Eur J Surg Oncol. 35(3):223-9, 2009
                                                              29. Gourin CG et al: A contemporary review of indications for primary surgical care of patients with squamous cell carcinoma of the head and neck. Laryngoscope. 119(11):2124-34, 2009
                                                              30. Guido A et al: Combined 18F-FDG-PET/CT imaging in radiotherapy target delineation for head-and-neck cancer. Int J Radiat Oncol Biol Phys. 73(3):759-63, 2009
                                                              31. Higgins KM et al: Treatment of early-stage glottic cancer: meta-analysis comparison of laser excision versus radiotherapy. J Otolaryngol Head Neck Surg. 38(6):603-12, 2009
                                                              32. McCoul ED et al: Meta-analysis of impaired vocal cord mobility as a prognostic factor in T2 glottic carcinoma. Arch Otolaryngol Head Neck Surg. 135(5):479-86, 2009
                                                              33. Becker M et al: Imaging of the larynx and hypopharynx. Eur J Radiol. 66(3):460-79, 2008
                                                              34. Blitz AM et al: Radiologic evaluation of larynx cancer. Otolaryngol Clin North Am. 41(4):697-713, vi, 2008
                                                              35. Chu EA et al: Laryngeal cancer: diagnosis and preoperative work-up. Otolaryngol Clin North Am. 41(4):673-95, v, 2008
                                                              36. Ferlito A et al: Selective neck dissection (IIA, III): a rational replacement for complete functional neck dissection in patients with N0 supraglottic and glottic squamous carcinoma. Laryngoscope. 118(4):676-9, 2008
                                                              37. Hristov B et al: Radiotherapeutic management of laryngeal carcinoma. Otolaryngol Clin North Am. 41(4):715-40, vi, 2008
                                                              38. Chong VF: Tumour volume measurement in head and neck cancer. Cancer Imaging. 7 Spec No A:S47-9, 2007
                                                              39. Connor S: Laryngeal cancer: how does the radiologist help? Cancer Imaging. 7:93-103, 2007
                                                              40. Mendenhall WM et al: Multidisciplinary management of laryngeal carcinoma. Int J Radiat Oncol Biol Phys. 69(2 Suppl):S12-4, 2007
                                                              41. Morton RP et al: Thyroid cancer invasion of neck structures: epidemiology, evaluation, staging and management. Curr Opin Otolaryngol Head Neck Surg. 15(2):89-94, 2007
                                                              42. Roh JL et al: 2-[18F]-Fluoro-2-deoxy-D-glucose positron emission tomography as guidance for primary treatment in patients with advanced-stage resectable squamous cell carcinoma of the larynx and hypopharynx. Eur J Surg Oncol. 33(6):790-5, 2007
                                                              43. Taguchi T et al: Concurrent chemoradiotherapy with carboplatin and uracil-ftegafur in patients with stage two (T2 N0 M0) squamous cell carcinoma of the glottic larynx. J Laryngol Otol. 120(6):478-81, 2006
                                                              44. Daisne JF et al: Tumor volume in pharyngolaryngeal squamous cell carcinoma: comparison at CT, MR imaging, and FDG PET and validation with surgical specimen. Radiology. 2004 Oct;233(1):93-100. Epub 2004 Aug 18. Erratum in: Radiology. 235(3):1086, 2005
                                                              45. Mendenhall WM et al: Management of T1-T2 glottic carcinomas. Cancer. 100(9):1786-92, 2004
                                                              46. Wax MK et al: The role of positron emission tomography in the evaluation of the N-positive neck. Otolaryngol Head Neck Surg. 129(3):163-7, 2003
                                                              47. Zinreich SJ: Imaging in laryngeal cancer: computed tomography, magnetic resonance imaging, positron emission tomography. Otolaryngol Clin North Am. 35(5):971-91, v, 2002
                                                              48. Ferlito A et al: Incidence and sites of distant metastases from head and neck cancer. ORL J Otorhinolaryngol Relat Spec. 63(4):202-7, 2001
                                                              49. Becker M: Neoplastic invasion of laryngeal cartilage: radiologic diagnosis and therapeutic implications. Eur J Radiol. 33(3):216-29, 2000
                                                              50. Reidenbach MM: The paraglottic space and transglottic cancer: anatomical considerations. Clin Anat. 9(4):244-51, 1996