Glottic Squamous Cell Cancer

Voice saving vertical hemi-laryngectomy may still be possible if the cancer is confined to only one vocal cord without extension.

Other lesions may mimic squamous cell cancer and invade the larynx, and these include thyroid cancer as well as chondroid tumors from the adjacent thyroid cartilage.

T - Staging of Glottic Cancer

T1: Limited to vocal cords. Normal mobility.

T1A: Limited to one vocal cord.

T1B: Limited to both vocal cords.

T2: Extends to supraglottis and/or subglottis and/or vocal cord mobility.

T3: Limited to larynx with vocal cord fixation.

T4: Invasion through thyroid cartilage and/or extra laryngeal extension.

Minute mucosal surface lesions may be difficult to discern on imaging, and this is often better done by the endoscopist. However, the job of the diagnostic radiologist is one of determining deep spread. Pay particular attention to:

Laryngeal cartilage invasion.

Transglottic extension.

Extra laryngeal extension.

Extension into adjacent fascial spaces in a vertical manner. These include parapharyngeal space and carotid space.

Regional lymph nodes including internal jugular chain of nodes and the midline delphian node.

Be observant for possible lung metastasis or secondary lung primary.

Needle biopsy of suspicious deep masses may be necessary under imaging guidance.

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