Types of cysts in the throat and effective treatment methods

A tumor in the throat is a complex concept that includes neoplasms that arise in the pharynx and larynx. This pathology also includes tumors that appear in the trachea and surrounding soft or bone tissues, in the area of ​​the vocal cords. Malignant or benign neoplasms can occur in any part of the throat, because the pharynx is also divided into the nasopharynx, oropharynx and swallowing department, and the larynx consists of several types of tissue - connective tissue, mucous, fibrocartilaginous. In the human throat there are a huge number of vessels and nerve endings that can be susceptible to cancer.

With cancer, there is also a high probability of damage to the lymph nodes located in the throat. In addition, on the front of the throat, just under the skin, is the thyroid gland, which can metastasize into a malignant neoplasm. Research shows that benign tumors and oncology in the tissues of the larynx and pharynx are most common in men aged twenty to forty-five years. Most formations of the pharynx and larynx have no symptoms at an early stage of the development of the disease, and therefore are discovered randomly or in later stages. Early diagnosis and prevention of tumor diseases lead to a decrease in the total number of throat cancers.

Causes

The exact reasons for the development of tumors in the throat have not been established, but it has been proven that the main factors are:

1. Hereditary predisposition;
2. Impact of external aggressive factors;
3. Chronic infectious inflammatory diseases of the throat.

A genetic factor occurs when one of the relatives has already encountered cancer of the larynx or pharynx. External factors include the following:

• smoking, including passive smoking;
• systematic exposure to alcohol;
• inhalation of coal or asbestos dust, benzene, petroleum products or phenolic resins in hazardous industries;
• addiction to spicy and salty foods;
• history of chemical or thermal burns.

Internal factors include various chronic diseases, such as tonsillitis, tonsillitis, pharyngitis, tracheitis, sinusitis, Epstein-Barr virus, infectious mononucleosis. Tumors often occur in people who, due to the nature of their work, put too much strain on their vocal cords (announcers, singers, especially opera singers, priests). Eighty to ninety percent of patients are men, so gender plays an important role in the occurrence of throat tumors.

Causes of laryngeal cancer and risk factors

There are only two main reasons for the formation of a malignant tumor:

1. Long-term inflammatory process. We are talking about a pathology that lasts for 5-10 years and differs in the intensity of its manifestation.
2. Improper tissue repair. In medicine, this process is also called perverted, which is characterized by the appearance of atypical (“irregular”) cells.

There are also certain diseases that are considered precursors to throat (larynx) cancer. That is, doctors believe that if they ever were, then sooner or later the formation of a malignant tumor will begin. These diseases include:

1. Dyskeratosis is a condition in which excessive formation of keratin protein occurs in the mucous membrane of the pharynx (larynx). Moreover, in medicine there are two variants of this disease - leukoplakia and leukokeratosis.
2. Pachyderma is a pathology associated with thickening of a limited area of ​​the mucous membrane on the inner surface of the pharynx (larynx). Diagnosis of this disease is difficult, since identifying the disease requires examining the affected tissue under a microscope. Please note: the likelihood of developing a malignant neoplasm of the pharynx will be high only if the pathological thickening of the mucosa is located in close proximity to the vocal cords. In other localizations, cancer cells never form.
3. Laryngeal papillomas. This disease is very common in adults, and the timing of the formation of malignant cells on papillomas cannot be accurately determined. Doctors suggest that these periods depend on the presence or absence of predisposing factors.

It is worth mentioning right away that the above pathologies of the throat (larynx) do not always develop into malignant tumors - with proper treatment, the risk of developing cancer is reduced by an average of 70%.

Factors that can trigger the development of throat (larynx) cancer include:

• Frequent screaming – implies constant vocal load;
• constant consumption of hot and spicy foods;
• alcohol abuse - the upper parts of the larynx (throat) are directly exposed to ethyl alcohol, which causes irritation and damage to the mucous membrane;
• smoking and occupational hazards - work at high temperatures, dusty rooms, inhalation of aggressive substances (phenolic resins, soot, benzene);
• inflammatory diseases of the throat (larynx), occurring in a chronic form - for example, laryngitis;
• scars on the mucous membrane of the throat, which can appear after syphilis, scleroma, burns and tuberculosis.

Classification

Tumors of the larynx and pharynx can be malignant or benign according to the nature of their course. Both of them can be congenital, that is, arising during intrauterine development, as well as acquired, developing throughout life. Benign tumors in the throat are observed ten times more often than malignant ones. Depending on what tissues they are formed from, such neoplasms are divided into:

• papilloma in the throat - from epidermal tissue;
• fibroma and polyp - from connective tissue cells;
• lymphangioma and hemangioma - from vascular cells;
• chondroma - made of cartilage tissue;
• lipoma - from adipose tissue;
• neuroma - from cells of nerve endings.

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The mixed type includes fibroangioma, consisting of cells of vascular and fibrous tissue, neurofibroma, formed from nervous and connective tissues, and others.

The most common malignant tumor in the throat is squamous cell carcinoma, occurring in seventy percent of cases. Most often these are neoplasms of the mucous membrane of the larynx or pharynx. In twenty percent of cases, a person is diagnosed with a tumor of a non-epithelial structure - lymphoma, sarcoma, lymphosarcoma, adenocarcinoma, neuroendocrine neoplasm.

Depending on the size of the tumor, the presence of metastases and the prevalence of the cancer process throughout the body, there are four stages of cancer development:

1. At the first stage, the neoplasm has not yet grown to a large size and may look like an ulcer. The tumor is localized in the supraglottic part, which has not yet led to a change in voice timbre.
2. At the second stage, the tumor can affect surrounding tissues, spreading from the supraglottic part to the subpharyngeal space. The vocal cords acquire unusual movement, hoarseness occurs, and the regional lymph nodes are not affected.
3. In the third stage, the oncological process moves to the glottis, the vocal cords can no longer move normally, one cervical lymph node on the side of the tumor is affected and increases to three centimeters.
4. The fourth stage is divided into three substages.

• 4A – the thyroid cartilage is affected, as well as the tissues that surround the larynx and pharynx. The oncological process can spread to the esophagus, thyroid gland, trachea. Metastases spread to the lymph nodes on both sides of the tumor, as a result of which they increase by more than six centimeters.
• 4B – cancer of the spinal canal, carotid artery, organs and tissues of the chest cavity occurs. Multiple metastases occur in the lymph nodes, the size of which can be of any size.
• 4C – metastasis occurs to distant organs.

Often the first signs of cancer appear only at the third stage, when surgical intervention is no longer effective, so it is important to periodically conduct routine examinations.

Laryngeal polyps

Polyps make up the largest portion of benign tumors of the larynx. They most often occur in males in adulthood. The reasons for their occurrence are the same factors as for singing nodules. At the onset of the disease, vascular ectasia and congestion occur in the submucosal glands of the larynx, localized in the anterior third of the vocal folds, which experience the greatest stress during phonation. Then, over the next three months, a polyp forms at this site. Chronic inflammatory diseases caused by harmful production factors (dust, vapors of caustic chemicals) are of great importance in its occurrence.

Pathological anatomy

. A laryngeal polyp usually appears as a single unilateral round tumor of a whitish-gray or red or even bluish color, often protruding into the glottis on a pedicle. Small polyps have a smooth surface, large ones may have a papillary appearance. They do not belong to neoplasms as such, but are the result of inflammatory hyperplasia of the vocal fold's own tissues.

Symptoms and clinical manifestations

. The main symptom of a vocal fold polyp is a violation of voice production. In the initial stage, when a small polyp is tightly fixed to the vocal fold, a change in the tone of the voice occurs and a violation of its clarity occurs. When the polyp enlarges and falls into the lumen of the glottis, the phenomenon of diplophony occurs - “splitting” of the voice.

Diagnostics

with modern laryngoscopy methods it does not cause any difficulties.

Differential diagnosis

in all cases it is carried out with malignant tumors of the larynx.

Treatment

surgical. A radically removed polyp very rarely recurs.

Symptoms

Symptoms of tumors in the throat may vary depending on the nature of the pathology. With benign neoplasms, there will be such signs as a feeling of a foreign object in the throat, soreness, periodic coughing, as well as difficulty breathing through the nose, a change in voice - hoarseness or nasal sound. Large tumors can impair swallowing and breathing function.

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Manifestations of malignant tumors are more pronounced. These include:

• a frequent dry cough without an infectious disease begins;
• a sore throat occurs, which is cutting in nature and can radiate to the ear or temple area on the affected side;
• palatine tonsils enlarge;
• hearing impairment may occur;
• damage to the vocal fold leads to a change in the voice or its loss;
• blood may be present in the sputum, which indicates the disintegration of the tumor;
• there is an unpleasant odor from the mouth;
• an inflammatory process develops in the periodontal tissues, leading to their loss;
• cervical lymph nodes become enlarged and painful;
• swelling of the throat and enlargement of the Adam's apple occurs.

At the final stages of pathology development, when the tumor begins to disintegrate, cancer intoxication occurs, as a result of which weakness appears, subfertile hyperthermia occurs, appetite disappears and body weight decreases. The person feels tired and unable to work.

If any signs appear, you must immediately visit a doctor to undergo diagnostic measures.

Laryngeal cysts

Most cysts of the laryngeal region are localized outside the laryngeal cavity - on the epiglottis or on the root of the tongue, but they can also occur in the ventricles of the larynx and on the aryepiglottic folds (see Fig. 2, 4

). On the vocal folds, small cystic formations can arise as a result of the transformation of polyps in this area. Most laryngeal cysts are retention cysts, formed as a result of blockage of the excretory ducts and expansion and hypertrophy of the walls of the acini. Laryngeal cysts contain serous fluid of varying viscosity, depending on the content of colloidal proteins in it. Very rarely, cysts of embryonic origin occur in the form of dermoid cysts, which are located on the valculae or epiglottis. Cysts located on the vocal fold can be confused with nodular formations.

Symptoms and clinical course

. Laryngeal cysts tend to grow extensively without invading surrounding tissues. For a long time they can be asymptomatic, but, having reached a certain size, they cause disturbances in swallowing (cysts of the epiglottis, aryepiglottic folds) or phonation and breathing (cysts of the vocal folds, ventricles of the larynx). Cysts pinched in the respiratory gap can cause an acute attack of suffocation.

Treatment

exclusively surgical. The method of removing a cyst is determined by its size and location (puncture, incision or biting out part of the wall, complete removal of the cyst by external access).

Diagnostics

If there is a tumor in the throat, diagnosis begins with collecting anamnesis and listening to the patient’s complaints. Next, the doctor conducts a palpation examination, during which he palpates the cervical lymph nodes and the neck itself. The doctor must use mirrors to examine the oral cavity, tongue, tonsils, and also take a smear from the mucous membrane of the throat. If the tumor is not visualized during the initial examination, but there is an enlargement of the lymph node, then fine needle aspiration is performed, after which the collected biomaterial is sent for histological examination, and the patient is sent for additional diagnostic measures:

1. Laryngoscopy and fibrolaryngoscopy - help to determine changes in surface topography, its color, and identify the presence of plaque. During the procedure, a targeted biopsy of suspicious tissue is performed.
2. Tracheoscopy is an examination of the trachea to determine the extent of the spread of the oncological process.
3. Ultrasound examination of the thyroid gland and cervical lymph nodes to detect metastases.
4. X-ray of the chest, jaw and intracerebral sinuses - for the same purpose.
5. Magnetic resonance or computed tomography with the introduction of a contrast agent are the most informative methods for determining the location, size and degree of growth of a tumor.

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In order to determine how much the vocal cords are immobilized and the shape of the glottis is changed, a study of phonetic properties is carried out through phonetography, electroglottography and stroboscopy. It is mandatory to take blood and urine to determine general clinical parameters, and also test for the presence of tumor markers. Only after a complete examination can the doctor prescribe therapy.

Treatment of throat cancer in Moscow

Laryngeal cancer, the symptoms and signs of which in men should not be ignored, can be cured with radiation or chemotherapy if diagnosed early. For throat cancer, one of the treatment methods is surgery.

Oncologists, together with experienced surgeons at the Yusupov Hospital, use minimally invasive techniques in the initial stages of the pathological process to treat a malignant tumor in the throat. The main task is not only to remove the tumor, but also to preserve the function of the organ.

The Yusupov Hospital has created comfortable conditions for inpatient treatment of patients. The clinic staff pays attention to all patients and provides them with psychological support. An important advantage of the Yusupov Hospital is the ability for relatives to visit the patient at a convenient time.

If you need a consultation with an oncologist, contact the Yusupov Hospital to obtain the information you are interested in and undergo diagnostics.

Oncology is a serious problem, however, this is not a death sentence. Early diagnosis and properly selected treatment gives a good chance of a full recovery. The article will discuss the initial signs of throat cancer and the actions that need to be taken when characteristic symptoms are detected.

Treatment

When tumors occur in the pharynx or larynx, treatment methods may be different, depending on the size of the tumor, its structure, and location. The most effective treatment for benign tumors is surgery. Small single polyps or fibroids are removed through endoscopic surgery using laryngeal forceps or a snare. For cysts, preliminary suctioning of the contents of the neoplasm is carried out, after which it is excised along with the membrane, the base is subjected to cryotherapy to prevent relapse.

If papillomatosis is detected, the pathologically altered area of ​​the mucosa is excised. Cancer treatment is carried out comprehensively - surgical removal of the tumor is used, with the addition of chemical and radiation therapy. For large tumors, partial resection of the larynx or pharynx can be performed with the installation of a temporary tracheostomy, and after its removal, pharynx surgery is performed.

Prognosis and prevention

The prognosis of benign tumors of the throat is favorable in most cases, especially if the pathology was discovered when the tumor is still small in size. If the throat tumor is malignant, then prognostic data depend on the stage at which the disease was detected. At the first stage, the five-year survival rate is approximately eighty percent, at the second stage - up to seventy-two, with a tumor of the third stage, up to fifty-five percent of patients survive, and at the fourth - no more than twenty-five people out of a hundred. Preventive measures include giving up bad habits, timely treatment of infectious diseases of the upper respiratory tract and avoiding other pathological factors.

Angioma of the larynx

Laryngeal angiomas are divided into hemangiomas and lymphangiomas. True hemangiomas are rare and, according to various authors, account for approximately 1% of all benign tumors of the larynx.

Hemangiomas

.
Structurally they are telangiectases, but more often cavernous angiomas predominate, which spread to the pyriform sinuses, valculae, tonsils, soft palate and can be combined with hemangiomas of the face and upper neck. Hemangiomas of the telangiectatic structure have the appearance of a red spot, slightly rising above the surface of the mucous membrane. When damaged, they bleed little. Cavernous hemangiomas (see Fig. 2, 3
) appear as space-occupying formations, are susceptible to spontaneous bleeding and bleed profusely when damaged.

Lymphangiomas

. These tumors are much less common than hemangiomas and are usually localized on the epiglottis, aryepiglottic and vocal folds, in the ventricles and in the subglottic space. They are paler in color and have a yellowish-pinkish color and contain a milky liquid.

Diagnosis

angiomas are identified according to the typical type of tumor; as for determining its prevalence, in some cases the method of contrast vasography, MRI, and fibrolaryngoscopy is used. Biopsy is contraindicated for any form of hemangioma due to the risk of profuse bleeding.

Differential diagnosis

carried out with fibroangiomatous polyps of the larynx, myxoma, sarcoma.

Treatment

. Due to the slow development of hemangioma and in cases where the tumor does not cause any subjective disorders, systematic observation should be limited. Small angiomas that cause phonatory disorders can be removed, followed by cauterization of the surface on which the tumor was located. For significant cavernous hemangiomas, some authors recommend ligating the external carotid artery on the corresponding side to reduce the likelihood of aneurysmal development of the process, the risk of bleeding, and as preoperative preparation. Large hemangiomas are removed using an external approach using a laryngofissure. The development of laser surgery has made it possible to significantly expand the indications for the removal of hemangiomas and perform it in newborns.