Silent Supraglottic Carcinoma

Abstract

In a review of 51 consecutive patients with previously untreated squamous cell carcinoma of the supraglottic larynx, five (9.8%) patients were found to have no mucosal abnormality on initial evaluation by both computed tomography (CT) and direct laryngoscopy. All five patients who manifested submucosal disease had at least one endoscopic procedure done with a biopsy negative for cancer before definitive diagnosis, resulting in an average delay from initial endoscopy to diagnosis of 19.8 weeks. These inapparent or "silent" neoplasms present unique problems in regard to establishing a diagnosis by routine biopsy techniques, even though CT reliably demonstrates their presence. Early diagnosis requires aggressive biopsy techniques based on CT findings.

Influence of CT on Tumor Classification of Laryngeal Carcinomas

“…Repeated examina tion with deep biopsies in both cases revealed the tumor after the CT examination. Consistent with other materials (1,5,6,8) most tumors in this region were advanced.…”

“…The problem of underestimating supraglottic tumors by clinical examination is well known (1,6). Tumors in this region may remain difficult to diagnose for a long period when restricted to the preepiglottic space, in which case the mucosa can be intact.…”

“…Most authors (1)(2)(3)(4)(5)(7)(8)(9)(10)(11) agree that one of the major advantages of CT is its ability to demonstrate definitive involvement of the laryngeal framework, which in most cases is unassessible for the clinician. Others (12), however, are critical, stating that a significant number of false-posi tives and false-negatives were found in their material.…”

MR imaging of primary malignant lymphoma in the larynx

“…To our knowledge, there are no reports in the literature of MR imaging appearances of primary laryngeal lymphoma [2,3,4,5,6,7]. This paper describes MR appearances in a patient with primary laryngeal lymphoma.…”

“…The mean age at diagnosis is 58 years (range 4±90 years) and the male-to-female ratio is 1.3 to 1. Despite the unfavorable histopathology of these tumors, they are radiosensitive; therefore, radiation therapy is the primary treatment of choice and the prognosis is good.To our knowledge, there are no reports in the literature of MR imaging appearances of primary laryngeal lymphoma [2,3,4,5,6,7]. This paper describes MR appearances in a patient with primary laryngeal lymphoma.…”