Imaging features in 35 cases of submucosal laryngeal mass lesions (original) (raw)
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A case report on submucosal laryngeal lesion: a diagnostic jinx
Journal of Research in Medical and Dental Science, 2015
Larynx plays an important role for activities like speech, swallowing & respiration. To preserve all these function early diagnosis & treatment of laryngeal disease is necessary. Laryngeal squamous cell carcinoma is the second most common cancer among head and neck cancers.
Non-Squamous Cell Neoplasms of the Larynx: Radiologie- Pathologie Correlation1
A variety ofbenign and maIignant non-squamous cell neoplasms may affect the larynx. Most of these uncommon laryngeal neoplasms are located beneath an intact mucosa, making diagnosis difficult widl endoscopy alone, and sampling ecrors may occur if only traditional superficial biopsies are performed. ln sorne laryngeal neoplasms, radiologic evaluation allows the cocrect diagnosis. Hemangiomas have very high signal intensity at T2-weighted magnetic resonance (MR) imaging and strong enhancement at both computed tomography (Cf) and MR imaging after administration of contrast material. Phleboliths, which are pathognomonic for he-mangiomas, are easily identified at cr. Chondrogenic tumors typically manifest with coarse or stippled calcifications at cr. Because of their high water content, chondrogenic tumors have very high signal intensity on T2-weighted MR images, whereas only moderate enhancement is observed after administration of contrast material. Lipomas typically manifest at both cr and MR imaging as homogeneous nonenhancing lesions. They are isoattenuating to subcutaneous fat at cr and iso-intense relative to subcutaneous fat with all MR pulse sequences. Metastases from renal adenocarcinoma typically demonstrate strong contrast enhancement and flow voids at MR imaging, and metastases from melanotic melanoma usually have high signal intensity on Tl-weighted MR images and low signal intensity on T2-weighted images owing to the paramagnetic properties of melanin. Although ra-diologic fmdings are nonspecific in most other non-squamous cell neoplasms of the larynx (eg, Kaposi sarcoma, hematopoietic tumors, tumors of the minor saIi-vary glands, metastases from amelanotic melanoma), cross-sectional imaging can play an important role in the diagnostic work-up of these unusual tumors by delin-eating the extent of submucosal tumor spread and directing the endoscopist to the appropriate site for the deep, transmucosal biopsies needed to establish the diagnosis. ln addition, cr and MR imaging are crucial for posttherapeutic monitoring and early detection of local recucrence. Abbreviation: AIDS = acquired immunodeficiency syndrome
Benign tumors of the larynx: a clinical study of 50 cases
Indian Journal of Otolaryngology and Head & Neck Surgery, 2009
Objective The study was undertaken to identify the common type of lesions, and the age, sex distribution, symptomatology, sites of involvement and prognosis of the same. Study design A two-year prospective study was conducted from January 2005 to December 2006. Setting The study was conducted at SMS Medical College, Jaipur, Rajasthan, India-a tertiary referral hospital. Patients A total of 50 patients with benign laryngeal lesions were included in the study based on symptoms such as hoarseness of voice, foreign body sensation, throat pain, neck mass and cough and with positive clinical fi ndings on indirect laryngoscopy and neck examination. The patients were in the age group of 14-63 years. All nonoperative cases and malignant cases were excluded. Diagnostic hematological and radiological investigations and therapeutic microlarygoscopic procedures were employed. Results A male preponderance with a male:female ratio of 2.5:1 was observed. Majority of the patients were in the age group of 21-30 years. Vocal cord polyps were observed to be the commonest type of lesions. In our study, hoarseness of voice, cough, foreign body sensation and throat pain were found to be the commonest symptoms. Out of the 50 patients in the study group, only 6% patients got complete relief with voice rest and vocal rehabilitation; 94% patients required surgery, which included microlarygoscopy and endolaryngeal surgery. There was no recurrence in cases of vocal polyps and nodules during the period of observation. Conclusion Microlaryngeal surgery and voice rest offer a cost-effective, useful and safe method for the management of benign laryngeal lesions. With the inclusion of lasers, they can be more precisely operated. As such, the standard treatment of choice in all types of benign tumors of the larynx should consist of a triad of approach by microlaryngeal surgery (either microscopic or endoscopic, with or without use of lasers), voice rest and vocal rehabilitation.
Specific Diagnostic Aspects in Benign Laryngeal Tumors – Mini Review
Les tumeurs bénignes à localisation laryngée sont des lésions présentant une importante variété histologique, sans symptomatologie clinique spécifique, mais dominée essentiellement par la dysphonie, affectant en proportions approximativement équivalentes les deux sexes. Elles peuvent évoluer dans certains cas vers des complications redoutables sur le plan fonctionnel, voire subir une transformation maligne en l’absence d’une thérapie appropriée et rapidement mise en pratique. Les auteurs cherchent à passer en revue les principales affections tumorales bénignes du larynx en fonction de leur type histologique, en présentant leurs par ticu larités à l’analyse anatomo-pathologique, afin que celle-ci permette d’établir un diagnostic précis et de certitude.
Clinico-pathological study of 50 cases of tumours of larynx
Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2013
The larynx serves to protect the lower airways, facilitates respiration and plays a key role in phonation. Based on anatomic location, the larynx is divided into the supraglottic larynx, the glottis or glottic larynx, and the subglottic larynx. The tumours of larynx can be divided into benign or malignant. Laryngeal granulomas, Vocal cord nodules, Vocal cord polyps are tumour-like lesions of larynx. Benign laryngeal tumors include a large number of lesions like papillomas, hemangiomas, fibromas, chondromas, myxomas, and neurofibromas. About 95% of laryngeal carcinomas are typical squamous cell tumours. Rarely adenocarcinomas are seen, presumably arising from mucous glands. The exact cause of laryngeal cancer is still unknown. Diagnosis is based on direct or indirect visualization of the larynx, supplemented by CT scan and confirmed by histopathological examination. The aim of the present study was to study the clinical aspects, histopathological patterns of tumours of the larynx to ...
Correlation of Endoscopic and CT scan Findings in Laryngeal Carcinoma
Journal of Medical Science And clinical Research, 2017
Background: Laryngeal carcinoma is a common cancer in Indian population. Early diagnosis and management of the disease can decrease the mortality rate of the disease. Endoscopy and computed tomography of larynx play vital roles in diagnosis of laryngeal carcinoma. Methods and Materials: In a prospective study conducted in Department of ENT and Head & Neck Surgery, M.L.B. Medical College, Jhansi, U.P. we correlated the endoscopic and CT findings of larynx of 24 cases of laryngeal carcinoma. Aims: To compare the endoscopic and CT larynx findings and correlation of them in diagnosing and staging of laryngeal carcinoma. Summary: Laryngoscopy is better in detecting early mucosal changes of laryngeal cancer of various subsites as compare to CT scan. The few sites like ventricle, paraglottic space, pre epiglottic space can't be assessed by laryngoscopy but can be better assessed by CT scan as well as the extention of disease to cartilage and neck. Both help in staging of laryngeal carcinoma. The Findings of endoscopy and CT scan and clinical staging can be confirmed by pathological staging of the disease. Conclusion: Laryngeal endoscopy and CT have their own advantages and disadvantages in diagnosing and staging of laryngeal cancer can be done more precisely when both endoscopic and CT findings are correlated.
European Archives of Oto-Rhino-Laryngology, 2009
Virtual endoscopy is becoming a widely used non-invasive clinical diagnostic tool. The present study was designed to compare the sensitivity and speciWcity of the conventional endoscopy and virtual laryngoscopy with respect to laryngeal masses. A total of 38 patients (20 males, 18 females, mean age 61 years) with the complaint of hoarseness were included in the study. Laryngeal mucosa, lumen and mass pathology were evaluated initially by direct endoscopy and then by virtual laryngoscopy during multislice CT of the larynx. Histopathologic evaluation of the masses was also made. The main pathology of the patients was found to be laryngeal masses (60% of patients, one mass for each patient), which were polyps (n = 8), papilloma (n = 4) and carcinoma (n = 11) according to histopathologic evaluation. Retrospective evaluation of 6 lesions detected in virtual but not in conventional laryngoscopy resulted with the Wnding of viscous-dense mucous secretion. On the contrary, three lesions detected by conventional laryngoscopy could not be detected by virtual evaluation. A total of six patients were evaluated and considered as normal both by conventional and virtual laryngoscopic examinations. Sensitivity of the virtual laryngoscopy was 88% (23/26) while its speciWcity was only 50% (6/12). Positive and negative predictive values were 79% (23/29) and 66% (6/9), respectively. Accuracy of the virtual laryngoscopy was 76% (29/38). Virtual laryngoscopy is not an alternative to conventional laryngoscopy but may assist direct endoscopy without causing additional radiation exposure or discomfort to the patient. The three-dimensional contribution to interpretation of the results and subsequent manipulation of the data can be used for educational and surgical purposes.
Endoscopic approach to hyperplastic laryngeal lesions: a literature review and personal experience
The Egyptian Journal of Otolaryngology, 2023
Background Presently, there is a lot of confusion in the identification and classification and no consensus regarding the management of hyperplastic laryngeal lesions (HLL). Conventional transoral microsurgery has some drawbacks and is not always possible. The purpose of the study was to identify criteria for preoperative detection of HLL with high malignant potential and to assess the effectiveness of flexible endoscopic surgery (FES) in the management of HLL. Methods A review of relevant English literature and a retrospective review of medical records of 37 patients with HLL, treated by FES, was performed. Results Endoscopic and histologic features of HLL are discussed. An endoscopic classification of HLL is proposed: chronic hyperplastic laryngitis (CHL), chronic hyperplastic laryngitis with keratosis (CHLK), leukoplakia, pachydermia, and verrucous neoplasia. The role of FES using different tools in the diagnosis and management of HLL is presented. We applied flexible endoscopic laryngeal surgery (FELS) for 37 patients (ages, from 20 to 77 years, men 34, women 3) with the following types of HLL: CHLK 5, leukoplakia 18, pachydermia 12, verrucous neoplasia 2. Tracheostomy was offered in 1 case of obstructive verrucous neoplasia with subsequent decanulation after successful endoscopic management. According to the data from the literature and our own observations, the following criteria seem to point to a HLL with high malignant potential: verrucous neoplasia, pachydermia, a lesion affecting more than a half of the vocal fold, mucosal hyperemia, high-grade dysplasia in biopsy samples. The expected result (total eradication of the visible lesion) was obtained in all of our cases (mean follow-up period 76 months). Invasive carcinoma developed subsequently in 2 patients that continued to smoke after surgery. All the patients that could be followed-up stated an improvement of their voice after surgery. Conclusion The following criteria can be used for preoperative detection of HLL with high malignant potential: verrucous neoplasia, pachydermia, a lesion affecting more than a half of the vocal fold, mucosal hyperemia, highgrade dysplasia in biopsy samples. Flexible endoscopic surgery, preceded by large flexible forceps biopsy, is a good alternative for HLL management. Diathermy snare is a useful tool for the diagnosis and first-line treatment in selected patients.
Clinicopathological Study of Benign Lesions of Larynx
Journal of Evolution of Medical and Dental Sciences, 2018
BACKGROUND Benign laryngeal lesions are a spectrum of laryngeal diseases where symptoms vary from discomfort in throat, pain in throat, change of voice to stridor. Prompt diagnosis, intervention and speech therapy will reverse the conditions in certain laryngeal lesions. Aims and Objectives-A clinical study was undertaken to analyse the age, sex distribution and symptomatology, sites of involvement and the prognosis of the common types of benign lesions of larynx. MATERIALS AND METHODS A total of 40 patients with benign laryngeal lesions were included based on symptomatology such as hoarseness of voice, foreign body sensation, throat pain, neck mass and cough with positive clinical findings on indirect laryngoscopy and neck examination. The patients ranged from 5-65 years. All non-operative cases and malignant cases were excluded. Diagnostic haematological and radiological investigations and therapeutic microlaryngoscopic procedures were employed. Study Design-A two years descriptive type of study from November 2013 to November 2015. Setting-A tertiary referral hospital. RESULTS A male preponderance with M: F ratio of 3: 2 was observed. Majority of the patients were in the 31-40 years' age group. Vocal polyps were the commonest type of lesion. In our study, hoarseness of voice, cough, foreign body sensation and throat pain proved to be the commonest symptoms. CONCLUSION Microlaryngeal surgery and voice rest offer a cost effective, useful and safe method.