title: Well and intermediate differentiated laryngeal chondrosarcoma: toward conservative surgery?
abstract: Chondrosarcoma of the larynx is a relatively rare malignant tumor. In the world literature, only 600 cases of laryngeal chondrosarcoma (LCS) have been reported. It is the most frequent non-epithelial tumor of the larynx (0.07-2% of all cancers), usually occurring on the cricoid. We present six cases of well-intermediate differentiated grade chondrosarcoma of the larynx, diagnosed between the fifth and seventh decades of life, in the absence of relevant risk factors. All cases were subjected to a conservative surgical approach, either endoscopic using remodeling transoral laser surgery, or open neck via a supratracheal partial laryngectomy (STL), sparing laryngeal function. All patients are free from recurrence with a minimum follow-up of 31 months. All were ultimately decannulated, are able to tolerate a quite normal diet and to speak satisfactorily. Conservative laryngeal surgery is effective because chondrosarcoma is often a low-grade tumor showing slow growth. The criteria for choosing the type of surgery was based on the age of the patient (elderly patient > favoring an endoscopic approach), on the rate of involvement of the cricoid and on the involvement of the cricoarytenoid joints (if possible to save a cricoarytenoid unit > favoring a STL). By extending the inferior limit of the resection to include a large part of the cricoid cartilage, supratracheal partial laryngectomies expanded the indications to some LCSs not involving the entire cricoid lamina sparing laryngeal function and avoiding the need for total laryngectomy.
authors: ENT Department, San Giovanni-Addolorata Hospital, Rome, Italy, valerio_damiani@me.com.
authors: Valerio
authors: V
authors: Damiani
authors: Erika
authors: E
authors: Crosetti
authors: Giuseppe
authors: G
authors: Rizzotto
authors: Angelo
authors: A
authors: Camaioni
authors: Giovanni
authors: G
authors: Succo
mesh_terms: D000368:Aged; D002813:Chondrosarcoma / Q000473:pathology / Q000601:surgery*; D003413:Cricoid Cartilage / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
references: Laryngoscope. 2006 Oct;116(10):1907-17
references: 17003702
references: South Med J. 1988 Apr;81(4):481-4
references: 3358173
references: Otolaryngol Head Neck Surg. 2001 Jun;124(6):634-40
references: 11391253
references: Laryngoscope. 2003 Oct;113(10):1817-9
references: 14520112
references: J Chronic Dis. 1987;40(5):373-83
references: 3558716
references: Ann Otol Rhinol Laryngol. 1990 Jul;99(7 Pt 1):515-23
references: 2195959
references: Eur Arch Otorhinolaryngol. 1999;256(6):271-6
references: 10456273
references: Ann Otol Rhinol Laryngol. 2011 Sep;120(9):603-7
references: 22032074
references: Am J Surg Pathol. 2002 Jul;26(7):836-51
references: 12131151
references: Laryngoscope. 2011 Nov;121(11):2375-80
references: 22020889
references: Laryngoscope. 1981 Nov;91(11):1904-12
references: 7300541
references: J Laryngol Otol. 2003 Aug;117(8):651-5
references: 12956923
references: Curr Opin Otolaryngol Head Neck Surg. 2004 Apr;12(2):98-105
references: 15167045
references: Rev Laryngol Otol Rhinol (Bord). 1972 Jan-Feb;93(1):23-38
references: 4626457
references: Acta Otolaryngol. 2000 Sep;120(6):680-8
references: 11099143
references: Biochem Biophys Res Commun. 2006 Jul 28;346(2):379-85
references: 16765318
references: AJNR Am J Neuroradiol. 1993 Mar-Apr;14(2):453-9
references: 8456728
references: Ann Otol Rhinol Laryngol. 2003 Aug;112(8):678-82
references: 12940664
references: Med Chir Trans. 1816;7:150-3
references: 20895274
references: Cancer. 1998 Jan 1;82(1):108-15
references: 9428486
references: Ear Nose Throat J. 2010 Jan;89(1):E6-E10
references: 20155689
references: Head Neck. 1994 Mar-Apr;16(2):127-34
references: 8021131
references: Head Neck. 2009 Feb;31(2):145-52
references: 18972422
references: Acta Otorrinolaringol Esp. 2010 Jul-Aug;61(4):262-71
references: 20096816
references: Dysphagia. 1999 Summer;14(3):139-45
references: 10341109
references: Arch Otolaryngol Head Neck Surg. 1990 Nov;116(11):1338-41
references: 2242267