Oncocytic lesions of the larynx

Eight cases of laryngeal oncocytic lesions treated at Toronto Western Hospital between 1957 and 1977 are reviewed. The typical clinical course was of a benign lesion with prolonged dysphonia. A smaller number with bulkier lesions developed symptoms of airway obstruction. The lesions were supraglottic and cystic. They were excised either endoscopically or via a laryngofissure. The pathologic features support the concept that the lesion represents a metaplasiahyperplasia, and therefore the term 'oncocytic cyst' is preferred to terms which imply a neoplastic process. Three patients with oncocytic cysts had associated squamous dysplasia of the vocal cord. Pathologically this supports the theory of tissue response to chronic irritation, since all three were heavy smokers. Clincially the finding necessitates longterm follow-up with a view to possible squamous cell carcinoma that may arise on the true cords. Follow-up in this series showed no recurrence of symptoms in six of eight cases, two being lost to follow-up.