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Glottic Cancer: A Metamorphosing Disease.

Steven M Zeitels1

  • 1Department of Surgery, Harvard Medical School, and Division of Laryngeal Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA zeitels.steven@mgh.harvard.edu.

The Annals of Otology, Rhinology, and Laryngology
|November 28, 2015
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A significant portion of glottic cancer patients are now non-smokers. This evolving disease presents with papillary morphology, distinct from traditional smoking-related cancers.

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HPVKTP laserglottal cancerglottic cancersmokingvocal cordvocal fold

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Area of Science:

  • Otolaryngology
  • Oncology
  • Pathology

Background:

  • Traditionally, glottic cancer has been strongly associated with smoking history.
  • Recent clinical observations suggest an increasing incidence of glottic cancer among never-smokers.

Purpose of the Study:

  • To investigate the prevalence of non-smoking history in a recent cohort of glottic cancer patients.
  • To characterize the clinical and morphological features of glottic cancer in never-smokers.

Main Methods:

  • Retrospective review of 100 glottic cancer patients.
  • Determination of smoking history for each patient.
  • Analysis of disease morphology and clinical presentation.

Main Results:

  • 31% of the 100 glottic cancer patients had no smoking history.
  • Non-smoker cases often exhibited exophytic, papillary, and highly vascular morphology, resembling recurrent respiratory papillomatosis (RRP).
  • Two patients were misdiagnosed with RRP, received cidofovir injections, and experienced accelerated cancer growth.

Conclusions:

  • Glottic cancer may be an evolving disease with decreasing reliance on smoking as a primary risk factor, potentially influenced by factors like HPV.
  • The papillary, angiogenic morphology in some glottic cancers is suitable for angiolytic laser treatments.
  • Caution is advised regarding cidofovir use in papillary glottic neoplasms due to potential for disease acceleration and resemblance to RRP.