Malignant tumors of the larynx: Clinicopathologic profile and implication for late disease presentation

Abstract

Background:Malignant laryngeal tumors are uncommon. Late presentation of the disease may worsen management outcomes. We described the epidemiologic, clinicopathologic profile, and management outcomes of laryngeal tumors in a tertiary health institution in Nigeria.Materials and Methods:An 11-year retrospective review of medical records of patients managed for malignant laryngeal tumor at the University College Hospital, Ibadan, Nigeria, was performed.Results:There were 97 patients comprising 74 (76.3%) males and 23 (23.7%) females with a mean age of 60.48 ± 12.15 years. The mean duration of illness was 7.3 ± 3.8 months. History of cigarette smoking and alcohol consumption was in 2.1% and 14.4% patients, respectively. The most common clinical presentations were hoarseness, cough, and dyspnea. Transglottis (91.8%) was the most common anatomic tumor location and 92.8% patients presented in advanced disease stage. Four histologic types were identified with squamous cell carcinoma accounting for 96.9%. About 92% patients had emergency tracheostomy and 56 (57.7%) patients had total laryngectomy. The postoperative complications were pharyngocutaneous fistula (5.2%) and peristomal recurrence (3.1%). The 5-year survival rate was 52.5%.Conclusions:Malignant laryngeal tumors are uncommon, but more females are getting the disease. Squamous cell carcinoma is the most common histologic variant. Late stage disease presentation and initial wrong diagnosis contributed to the poor management outcome.

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“…[ 2 ] The defective mucosa apposition observed might have contributed to earlier cases of PCF reported in this environment. [ 11 ] In this present study, no patient developed early PCF (within 30 days), unlike 5.2%–11.9%, the prevalence of PCF in the early reports from our department. [ 11 12 ]…”

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“…S. Marc Stokes et al showed that nasopharyngeal angiofibroma presents as a nasal mass or obstruction o with repeated episodes of epistaxis [20]. Swelling of the lymph nodes in the neck is the initial presentation in many patients of nasopharyngeal carcinoma [21].…”

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“…14,16 Ogura et al reported glottis as the common site (50-60%) and Fasunla et al reported tranglottic as the most common site of presentation in laryngeal carcinoma. 6,10 Glottis carcinoma is reported as common laryngeal cancer in western literature while in Indian studies supraglottis remain the commonest site. Glottic cancer produces symptoms like hoarseness in very early stages.…”

“…This may be connected to frequent exposure to inhaled carcinogenic substances, irritants and malnutrition. 6,7 Patients of laryngeal and hypopharyngeal malignancy usually present with change in voice which may be due to malignancy arising from the vocal folds, infilteration of tumor into the paraglottic muscles, infilteration of recurrent laryngeal nerve. Other symptoms with which patients present are respiratory distress, dysphagia, cough, haemoptysis, neck swelling.…”