Cartilaginous tumours of the larynx

Cartilaginous tumours of the larynx are rare. Chondrosarcomas represent the most common sarcoma involving this site. A series of seven patients with the diagnosis of chondrosarcoma of the larynx from the cancer registry at the University of Michigan Medical Center from 1975 to 1997 and one recent case from the Ann Arbor Department of Veterans Affairs Hospital were identified. One patient with a laryngeal chondroma was also included in the series. Pertinent clinical, pathologic, and therapeutic data were reviewed. In three of the nine patients, tumours involved the thyroid cartilage; the remainder, including the chondroma, arose from the cricoid cartilage. Four of the chondrosarcomas were histopathologic grade I, three were grade II, and one was grade III. Surgical treatment of the chondrosarcomas included five total laryngectomies, three laryngofissures with resection, and a partial cricoid resection. Six patients are alive without disease, including one patient who had direct spread to the thyroid gland and a peristomal recurrence that was excised. The patient with a grade III tumour developed pulmonary metastases 6 months after total laryngectomy and radiation therapy and died. One patient died of other causes. These findings confirm previous reports that chondrosarcomas are usually slow growing and demonstrate an indolent clinical course and that low-grade chondrosarcomas arising in the larynx may be excised with close surgical margins without compromising survival. This series suggests that local recurrence of low-grade lesions can be salvaged surgically, even after total laryngectomy, and that high-grade chondrosarcomas, although exceedingly rare, are much more aggressive neoplasms with a greater tendency to metastasize.