A series of 77 cases of verrucous carcinoma of the larynx is presented. The tumor is relatively rare and the present series has been selected from 2,398 primary and recurrent malignant neoplasms of the larynx and hypopharynx evaluated at the Department of Otolaryngology of Padua University during the period from January 1966 to December 1978. The median age of patients was 58 years. The tumor appears to be exophytic, broadly implanted and fungating in aspect, with papillary fronds and a locally invasive character. It is composed of highly differentiated epithelial squamous cells covered by a thick keratinized layer arranged in deeply invaginated folds. Cellular response in tumor stroma is marked, and the neoplasm has a low‐grade malignancy. Close cooperation between the pathologist and the clinician is needed in order to establish the nature of the lesion, which looks clinically malignant but may appear histologically benign. Benign responses such as hyperkeratosis, acanthosis, or the presence of a benign papillomatous area necessitate further investigation with another biopsy examination from deeper layers. The elective treatment is surgery, as irradiation may cause anaplastic transformation with metastatic spread. Neck dissection is not indicated as this laryngeal tumor has so far never metastasized to cervical lymph nodes or to other organs.

\s=b\ Laryngeal metastases are uncommon, particularly if we consider only secondary involvement from the remote primary neoplasm, via lymphohematogenous dissemination. In the 21-year period from 1966 to 1986, only seven cases of secondary laryngeal cancers were observed at the Department of Otolaryngology of Padua (Italy) University. A review of the world literature resulted in the identification of 113 previously reported cases. Cutaneous melanoma is the neoplasm most frequently metastasizing to the larynx, but adenocarcinoma may also often occur, especially from renal origin. A correct differential diagnosis from primary laryngeal cancer is most important. Identification of tumor location beneath intact mucosa, use of particular biochemical and histochemical stains, and electron microscopy may assist in establishing the presence of a metastatic growth. The prognosis is almost generally unfavorable because laryngeal involvement often occurs with metastases to other organs.

After describing 4 new cases of malignant fibrous histiocytoma of the larynx (3 cases had been recently published), the authors review the literature, from which it appears that 16 such lesions of the larynx have been reported (including their 7 cases). Malignant fibrous histiocytoma usually occurs in the soft tissues, tendons and joints of the upper and lower extremities, and is uncommon in the head and neck--though not exceptional. The lesion is a mesenchymal tumor probably of histiocytic origin and may be divided into 6 subtypes, i.e., pleomorphic, fibrous, giant cell, angiomatoid, myxoid and inflammatory, to be distinguished on the basis of the predominant feature. The tumor has an aggressive biologic behavior as it tends to recur and to metastasize to distant organs. The treatment of choice is surgery and adjuvant combination chemotherapy which at times may improve the survival rate.

The present paper is a clinico-pathological study of 8 cases of small cell (‘oat cell’) carcinoma of the larynx and hypopharynx investigated at the Section of Pathology of the ENT Department of Padua University during the last 14 years (from January 1966 to December 1979). Besides a review of the world literature, several problems connected with terminology, histogenesis and pathologic patterns (microscopic, histochemical and ultra-structural) are examined, together with the differential diagnosis, clinical aspects and therapeutic approach. The association of small cell carcinoma with squamous cell carcinoma both in the larynx and hypopharynx is reported.

No abstract