Aspects on laryngeal cancer based on whole organ sections

Whole organ sectioning of laryngectomy specimens has been applied since quite a few years to increase our knowledge of the histopathological behavior of laryngeal carcinoma. The laboratory techniques have been successively refined with shortening of the processing time and with improved histological results. The larynx may be cut in the coronal, sagittal or in the transverse plane, which has become more actual for comparison between computed tomograms and histopathological findings. The growth and spread of laryngeal cancer is determined by the site of origin. Glottic carcinomas often invade the thyroid cartilage in the anterior commissure area and extend outside the larynx through cartilage or by extending subglottically and then through the crico-thyroid membrane. More extensive glottic carcinomas with supra- and/or subglottic extension may spread laterally through the crico-thyroid space. This way of spread is very characteristic for tumors surrounding the laryngeal ventricle--"transglottic carcinomas." Supraglottic carcinomas show a high tendency to invade the pre-epiglottic space. Despite an advanced size they tend to be confined to the supraglottic region, but may especially when ulcerated extend down to the glottic region in the anterior midline. Primary subglottic carcinomas are rare but tend to be advanced when diagnosed, having a circumferential growth with extension up into the vocal cord muscles. They may invade the laryngeal framework and spread outside the larynx through the crico-thyroid membrane. By using the whole organ sectioning technique we have gained further knowledge of the strength and weaknesses of our clinical and radiological diagnostic methods and we have a possibility to compare the radiographic findings with the histopathological sections.(ABSTRACT TRUNCATED AT 250 WORDS)