Chondrosarcoma of the larynx. (Imaging Clinic).

The diagnosis of laryngeal chondrosarcoma is likely to be delayed because of its infrequent occurrence and its indolent pattern of growth. (1) Submucosal tumors can arise from any of the supporting structures of the larynx. Of these tumors, perhaps the most easily diagnosed by imaging is the chondroid tumor, which arises from the cartilage of the larynx. It is also one of the most common submucosal lesions.

Chondroid tumors can be benign or malignant, although many are eventually characterized as low-grade chondrosarcomas. Their growth tends to be slow and can cause a gradual compromise of the vocal folds and/or airway, resulting in hoarseness and increasing dyspnea. (2) The cricoid cartilage is the most common site of involvement (80%); the thyroid cartilage is the second most common site. (1)

Direct laryngoscopy might detect a submucosal mass. These lesions can be clearly seen on computed tomography (CT). In these cases, the cartilage tends to be expanded rather than infiltrated by the process from the external surface (figure 1). Calcifications within the expanded mass are very characteristic of these lesions (figure 2). In order to preserve laryngeal function, every effort should be made to take a conservative surgical approach.

From the Department of Radiology (Dr. Palacios) and the Department of Otorhinolaryngology (Dr. Friedlander), Louisiana State University Health Sciences Center, New Orleans.

References

(1.) Curtin HD. Imaging of the larynx. In: Valvassori GE, Mafee MF, Carter BL, eds. Imaging of the Head and Neck. New York: Thieme Medical Publishers, 1995:366-89.

(2.) Shinhar S, Zik D. Issakow J, Rappaport Y. Chondrosarcoma of the larynx: A therapeutic challenge. Ear Nose Throat J 2001 :80:568-70, 572, 574.