Cartilaginous Tumors of the Larynx

Abstract

Cartilaginous tumors of the larynx, while rare, will on occasion be encountered by the otolaryngologist in routine daily practice. True laryngeal chondromas are exceedingly rare, and as a consequence, a putative diagnosis of chondroma should be viewed with suspicion. On pathologic examination, laryngeal chondromas usually prove to be small lesions (less than 2 cm in maximum dimension) and may arise in children or adults. Laryngeal chondrosarcomas, by contrast, usually prove to be larger lesions (exceeding 3 cm in greatest dimension) and are typically found in adults. While high-grade chondrosarcomas are readily identifiable on light microscopic study, the distinction between a chondroma and a low-grade chondrosarcoma is often not so clear-cut. Some low-grade chondrosarcomas may show a slight increase in both cellularity and cytologic atypia when compared with chondromas, but the two patterns often overlap. When faced with a limited biopsy specimen of a laryngeal cartilaginous lesion in which neither increased cellularity nor recognizable cytologic atypia is found, a diagnosis of “cartilaginous tumor without obvious evidence of malignancy — further classification dependent on examination of the lesion in its entirety,” or words to this effect, is recommended.