In the human larynx, like in any other organ, neoplasms can form. This occurs under the influence of various factors that contribute to tissue proliferation or degeneration. In this case, it is important to detect and eliminate the problem as soon as possible, because the tumor can be dangerous to health and even life. Tumors of the larynx are divided into benign and malignant.
The Oncology Department of the Yusupov Hospital deals with the diagnosis and treatment of various benign or malignant tumors. The clinic has modern expert-class equipment, with the help of which the most accurate visualization of the pathological process is carried out, indicating its size, the involvement of other organs and the stage of metastasis. Oncologists use only standardized treatment protocols approved throughout the world.
Benign neoplasms of the larynx
Benign neoplasms are characterized by slow tissue proliferation, the absence of metastases or invasion of surrounding tissues, and the absence of uncontrolled growth. They can be congenital or acquired (that is, appear during life). Benign tumors originate from various tissue structures: blood vessels, cartilage and connective tissue, nerve endings, and mucous glands. Often, the development of a congenital tumor is associated with a genetic predisposition, the effect of teratogenic factors on the fetus during pregnancy (rubella, toxoplasmosis, syphilis, HIV, drugs with embryotoxic effects, radiation). Acquired tumors appear when the immune and endocrine systems are disrupted, smoking, inhalation of fine dust, and excessive stress on the vocal cords.
Kinds
The main clinical manifestation of a laryngeal tumor is a change in voice (hoarseness, hoarseness). Patients may also complain of sore throat, discomfort and frequent cough. The symptoms of this pathology largely depend on the type, size and location of the tumor. There are the following types of benign tumors of the larynx:
Lipomas are neoplasms consisting of adipose tissue, in most cases they are yellow in color and located on a stalk.
Chondromas are benign tumors that originate from cartilage tissue. They have a hard consistency and are prone to malignancy.
Laryngeal fibroids are formed from connective tissue. Fibroids have a spherical shape and are localized on the upper surface or on the side of the free edge of the vocal cord. These neoplasms can range in size from 5 to 15 mm. These tumors are located on a stalk; they usually have a smooth, gray surface. Sometimes a fibroma may have many blood vessels, in which case its color takes on a red tint. A symptom of fibroma is a change in voice; if the tumor is large, breathing problems may occur.
Laryngeal angiomas have a predominantly congenital etiology and develop from cells of vascular tissues. Most often, single neoplasms occur.
A feature of tumors developing from blood vessels (hemangiomas) is the ability to grow into nearby tissues and frequent hemorrhages. Such neoplasms are colored red.
Tumors of lymphatic cells (lymphangiomas) are not prone to invasive growth and are usually yellowish in color.
Laryngeal papillomas appear in adults and are represented by dense fungal-like growths with a wide base. Such neoplasms are often isolated. The color of papillomas varies from whitish to red, depending on the intensity of their blood supply. Sometimes papillomas tend to spread to the tracheal mucosa.
In childhood, juvenile papillomas can be observed; most often they appear in children from one to five years of age, and they tend to disappear on their own during the child’s puberty. Children often develop multiple papillomas that affect large areas of the laryngeal mucosa; this phenomenon is called papillomatosis - visually it resembles cauliflower. Usually the pathological process is localized on the vocal folds, but in some cases it may spread to the subglottic region, epiglottis, trachea or arytenoid folds.
Laryngeal cysts, like angiomas, in most cases are congenital. The mechanism of development of cysts is the modification of gill slits in the process of disturbances in the embryonic development of the fetus. When the excretory ducts of the laryngeal mucosa are blocked, retention cysts may develop. Retention cysts occur only in childhood. This type of benign neoplasm rarely reaches large sizes, so they are characterized by an asymptomatic course.
The severity of pain in benign tumors depends on the size and location of the tumor process. In the early stages of development, this type of tumor is asymptomatic. As it grows, compression of nearby tissues, blood vessels and nerve endings occurs, leading to a nagging, aching pain.
Squamous cell keratinizing carcinoma of the larynx
A malignant tumor can develop in any part of the throat, but in most cases the tumors are localized in the pharynx and epiglottis. Squamous cell carcinoma of the throat is presented in two forms: keratinizing and non-keratinizing, differing in histological structure.
Squamous cell keratinizing carcinoma is formed from epithelial cells prone to keratinization. This form of the disease is characterized by a slow course and rare metastases. Compared to the non-keratinizing form, malignant formation is more easily amenable to complex treatment.
Squamous cell keratinizing oncology is a lumpy formation with clear boundaries, which is covered with tiny scales. The affected area may vary in size and shape. The danger of this form of throat cancer is that if not treated correctly, metastases can penetrate the lymph nodes.
Squamous cell keratinizing cancer of the larynx is successfully treated. After surgical removal of the tumor and chemotherapy at the initial stage of the pathological process, the survival prognosis reaches 98%.
Oncologists at the Yusupov Hospital pay special attention to patients diagnosed with cancer. The most important task of the oncology clinic specialists is to preserve the ability of patients with throat cancer to eat and speak properly.
Treatment options for laryngeal cancer
Treatment of laryngeal cancer is aimed at removing the cancer tumor, destroying metastases if they have already formed, and restoring swallowing, respiratory and vocal function. The method of therapy is determined depending on the extent of the process, the location of the tumor and the rate of division of pathological cells.
There are 3 main treatment methods used:
- radiation therapy,
- chemotherapy,
- surgical removal of the tumor.
Often, the doctor decides to combine several treatment methods at the same time. The patient must strictly follow all the doctor's recommendations.
Pharyngeal cancer is very sensitive to radiation. Therefore, therapy begins with this method. The process of cell division is inhibited, and the tumor slows down or stops growing. The course of radiation therapy is carried out over 7-8 weeks, sometimes the tumor begins to regress. The method is effective only in stages 1 or 2. The disadvantage of this method is that healthy tissues are affected and negative symptoms develop in the form of baldness and an irreversible change in the timbre of the voice.
Chemotherapy is used infrequently, as it is an ineffective technique. Only with cancer of the upper pharynx there are results. The drug is administered intravenously, so the entire body receives a negative effect. Patients suffer from dry mouth, vomiting, and general weakness.
Tumor removal
When the stage of development of the disease allows, the doctor seeks to remove the tumor while preserving the larynx itself. In rare cases, the organ is removed completely. If the tumor spreads to both vocal cords, they cannot be saved.
Successful surgical removal of an oncological tumor is possible at stages 1-2. After the intervention, an endoprosthesis is installed to prevent postoperative narrowing of the larynx.
In advanced stages of cancer, the doctor may have to remove nearby lymph nodes. In most situations, it is possible to save half or a third of the larynx.
Squamous cell nonkeratinizing laryngeal cancer
The most complex and lengthy therapy is required for patients diagnosed with squamous cell non-keratinizing laryngeal cancer. This type of malignant tumor is characterized by erosion and ulceration on the surface of the tumor.
In non-keratinizing cancer, oncologists note the rapid growth of the tumor and its spread to nearby anatomical structures. The prognosis for this form is less favorable, which is explained by early metastasis.
Oncologists at the Yusupov Hospital have extensive experience in treating various forms of squamous cell cancer. The comprehensive therapy programs developed for patients are based on evidence-based techniques. Specialists at the Oncology Clinic draw the attention of patients to the fact that it is impossible to diagnose the disease on their own, so to undergo an examination you should contact the diagnostic center of the Yusupov Hospital.
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Laryngeal cancer: symptoms, forms
The first manifestations of laryngeal cancer include:
- swallowing dysfunction;
- breathing problems;
- soreness, discomfort;
- cough.
With metastasis, symptoms can be supplemented by lesions of the lymph nodes; the location of metastases is the lower jugular lymph nodes. Distant metastasis occurs extremely rarely, in no more than 5% of cases. It is rare, but it happens when metastases spread to the liver, organs of the digestive system, and bones.
Laryngeal cancer manifests itself as a voice disorder; in parallel, the patient feels discomfort when speaking and pain. Pain may also be associated with the breakdown of tissue of a malignant tumor or its progressive growth. In this case, respiratory failure is observed during moderate physical exertion, but already at a later stage it manifests itself for no apparent reason. As the tumor grows, the body adapts to hypoxia. But under the influence of unfavorable factors such as cold, secondary infections, metastases, allergic reactions, acute stenosis can develop, which poses a danger to the patient’s life.
Reasons for the development of the disease
Laryngeal cancer is always preceded by changes in the organ or tissues, which are usually caused by such unfavorable factors (or a combination thereof) as:
- smoking;
- alcohol abuse;
- prolonged inhalation of dusty hot air, various gases (including exhaust), fumes of acids, alkalis, gasoline and oils;
- pre-tumor tissue changes, long-term chronic inflammation and benign tumors (fibromas, papillomas, cysts);
- Regular strain on the vocal cords;
- Difficult environmental situation;
- Work in hazardous industries.
Symptoms
Signs of the disease are very varied and depend on the shape and location of tumor growth and the degree of its spread. The initial period of the disease is characterized by minor and often hidden symptoms. The following symptoms should alert you:
- hoarseness or other voice changes;
- swelling in the neck area;
- sore throat and discomfort when swallowing, sore throat;
- sensation of a foreign body in the larynx when swallowing;
- persistent cough;
- earache;
- exhaustion and general weakness;
- weight loss.
Diagnosis of stage 3 laryngeal cancer
Laryngoscopy
In order to diagnose stage three laryngeal cancer, several methods are used:
- laryngoscopy - an instrumental examination method that involves a thorough examination of the pharynx by a specialist, mucous membranes and vocal folds to visually detect a tumor;
- tracheoscopy, necessary to determine the extent of the cancer process within the trachea (this method is often used if a resection of the larynx has been performed, as well as if metastasis in the trachea is suspected);
- biopsy – collection of small tissue fragments for the purpose of histological examination;
- CT and MRI - diagnostic methods that allow you to determine the location and size of tumor formation, the degree of its prevalence;
- Ultrasound (ultrasound examination of the neck), necessary to identify the possible presence of metastases in the lymph nodes.
Differential diagnosis makes it easier to differentiate between stage 3 squamous cell carcinoma of the larynx and other diseases (benign tumors, syphilis, tuberculosis). Making a diagnosis can be complicated by secondary inflammation or the formation of oncology in areas where a specific infection develops.
After a biopsy, atypical cells may not be detected. In cases where other studies give reason to suspect squamous cell carcinoma of the larynx, several additional samples will be taken from different parts of the tumor, as well as a biopsy of regional lymph nodes.
Diagnostics
The larynx and laryngopharynx are located deep, so diagnosis presents certain difficulties. Using a special instrument, which is a flexible thin tube with an illuminator, the nasal cavity, larynx and hypopharynx are carefully examined. If a suspicious lesion or tumor is detected, a biopsy is performed (taking a piece of tissue for examination). The oncology clinic of the Yusupov Hospital uses the following instrumental methods for diagnosing tumor-like formations of the larynx:
- Computed tomography (CT) makes it possible to determine the size of the tumor and its spread to the lymph nodes and surrounding tissues;
- A barium contrast study of the esophagus provides additional information about the tumor;
- A biopsy is the only method that allows us to confidently judge the presence of a tumor. A biopsy may involve taking a piece of tissue or puncturing the tumor with a needle.
On the recommendation of a clinical oncologist, a PET-CT study may be prescribed to determine the stage of the disease (if it is necessary to clarify treatment tactics), as well as to assess the response to treatment (usually 9-12 weeks after its completion).
Treatment
Treatment can be conservative or surgical, depending on the location of the tumor in the larynx and its size. Nowadays, it is no longer enough to simply cure the patient. Doctors are trying to preserve the larynx. Therefore, treatment usually begins with conservative (radiation or chemoradiotherapy) treatment. Benign neoplasms of the larynx require only planned surgical treatment. Removal is carried out under local anesthesia, if the tumor is located below the collarbone, everything higher - only with intubation.
Treatment tactics for patients with laryngeal cancer are developed by a clinical oncologist. This takes into account the type of tumor, the degree of spread of the disease, the current condition of the patient, his age, and concomitant pathologies. If necessary, all treatment methods for patients with cancer of the larynx and hypopharynx can be used: surgery, radiation (radiotherapy for laryngeal cancer) and chemotherapy for laryngeal cancer. Chemotherapy is not used as an independent treatment method for laryngeal cancer. Its combination with radiation or surgical methods significantly improves results. A combination treatment method is often used - radiotherapy for laryngeal cancer, chemotherapy and surgery.
After the main treatment of throat cancer, specialists at the Yusupov Hospital carry out rehabilitation aimed at restoring lost functions and improving the general condition of the patient. Solving aesthetic problems is an important task for throat cancer, which is successfully performed by surgeons at the Yusupov Hospital.
If you have been diagnosed with squamous cell carcinoma of the larynx or there is suspicion of this disease, contact the oncology clinic of the Yusupov Hospital. Highly qualified specialists will help you solve any oncological problem.
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Author
Causes
At the moment, experts find it difficult to indicate the reasons why squamous cell carcinoma of the larynx developed in some people, while in others everything turned out fine. However, they identified predisposing factors that prompted the occurrence of atypia in squamous epithelial cells:
- Precancerous chronic or acute conditions that specifically affect epithelial tissue - laryngitis, papillomatosis, pachydermia or nicotine leukokeratosis, polycystic laryngeal disease, leukoplakia.
- Abuse of tobacco products - many years of experience as a smoker, constant inhalation of tobacco smoke, which contains a huge amount of carcinogenic substances, thermal burn of the larynx - all this serves as a favorable background for the formation of a focus of atypia.
- Having suffered burns from toxic liquids, for example, in people prone to alcohol abuse, especially of low quality, a tumor focus is often diagnosed directly in the larynx and esophagus.
- Unfavorable environmental situation - residents of large cities, where there is a high concentration of various harmful substances in air flows, are at risk for cancer pathologies.
- Work activity that requires constant tension on the vocal cords - many teachers suffer from such a professional illness as chronic laryngitis, which is a precancerous condition.
- The habit of drinking too hot tea, the predominance of an excessive amount of spices in dishes - constant microdamage to the laryngeal mucosa also negatively affects health.
A thorough history collection in most cases helps a specialist determine the true root cause of the disease. If this does not happen, the diagnosis indicates idiopathic laryngeal cancer.
Bibliography
- ICD-10 (International Classification of Diseases)
- Yusupov Hospital
- Cherenkov V. G. Clinical oncology. — 3rd ed. - M.: Medical book, 2010. - 434 p. — ISBN 978-5-91894-002-0.
- Shirokorad V.I., Makhson A.N., Yadykov O.A. The state of oncourological care in Moscow // Oncourology. - 2013. - No. 4. - P. 10-13.
- Volosyanko M.I. Traditional and natural methods of preventing and treating cancer, Aquarium, 1994
- John Niederhuber, James Armitage, James Doroshow, Michael Kastan, Joel Tepper Abeloff's Clinical Oncology - 5th Edition, eMEDICAL BOOKS, 2013
