Neoplasms Metastatic to the Larynx: A Systematic Review

Metastatic involvement of the larynx from nonhead and neck primary tumors is an exceptionally rare event, frequently misdiagnosed as a primary laryngeal lesion and at risk of inappropriately aggressive surgical management. This systematic review aimed to define the most common primary sources, clinical features, diagnostic workup, treatment, and survival outcomes of tumors metastatic to the larynx from distant sites.

A comprehensive search of PubMed, Web of Science, and Scopus identified original English-language reports published between 1984 and 2026, screened independently by two reviewers according to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) recommendations.

A total of 83 articles were included, comprising 113 patients with histologically confirmed laryngeal metastases; the evidence consisted exclusively of single case reports and small retrospective series. Patients were predominantly older men with a mean age of 63.6 years. The most frequent primary site was the prostate (26.5%), followed by kidney (18.6%), colorectum (14.2%), skin melanoma (13.3%), lung (8.8%), and breast (6.2%). The supraglottis was the most commonly involved subsite, and the cartilaginous framework was affected in nearly one-quarter of cases. The median interval between primary diagnosis and laryngeal metastasis was 36 months, although the laryngeal lesion preceded or coincided with the primary in roughly one-fifth of patients. Hoarseness, dyspnea or stridor, and dysphagia were the dominant symptoms, clinically indistinguishable from primary laryngeal tumors. Treatment was heterogeneous and largely conservative or palliative, and overall survival was generally measured in months.

Laryngeal metastasis should be suspected whenever a laryngeal mass arises in a patient with a known or suspected extralaryngeal malignancy, prompting whole-body staging before biopsy and a multidisciplinary, individualized management strategy.