title: Glottic Cancer: A Metamorphosing Disease.
abstract: OBJECTIVE
  Conventional wisdom is that the overwhelming majority of glottic cancer patients have a smoking history. However, in recent years observations suggested that an increasing number of glottic cancer patients had never been smokers. Therefore, an investigation was done examining the incidence of having a smoking history in a recent cohort of glottic cancer patients.
  
  
  METHODS
  Retrospective review of 100 patients with glottic cancer to determine those reporting never having smoked.
  
  
  RESULTS
  Thirty-one of 100 did not have a smoking history. Clinical observations of those cases revealed that the disease morphology tended to be exophytic, papillary, and very vascular, often resembling recurrent respiratory papillomatosis (RRP). Remarkably, 2 of 31 were initially treated elsewhere assuming they had RRP and underwent 5 cidofovir injections. Both presented with advanced cancer, and the disease growth markedly accelerated coincident with the injections.
  
  
  CONCLUSIONS
  Observations herein provide new insights that glottic cancer may be an evolving disease in which smoking is less exclusive, not unlike HPV-induced pharynx cancer. Similar to RRP, the angiogenic papillary disease morphology is well suited for voice-preserving angiolytic KTP laser treatment. Given the resemblance of some glottic cancers to RRP, great care should be taken when using cidofovir for papillary glottic neoplasms.
authors.affiliation: Department of Surgery, Harvard Medical School, and Division of Laryngeal Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA zeitels.steven@mgh.harvard.edu.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Zeitels
mesh_terms: D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery / Q000821:virology; D000077404:Cidofovir; D003596:Cytosine / Q000031:analogs & derivatives / Q000627:therapeutic use; D003951:Diagnostic Errors; D005260:Female; D005931:Glottis / Q000000981:diagnostic imaging / Q000601:surgery*; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery / Q000821:virology; D006801:Humans; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery / Q000821:virology; D007828:Laryngoscopy; D053685:Laser Therapy; D053844:Lasers, Solid-State / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000627:therapeutic use; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000188:drug therapy; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology*; D000077195:Squamous Cell Carcinoma of Head and Neck
chemical_list: D000998:Antiviral Agents; D063065:Organophosphonates; D003596:Cytosine; D000077404:Cidofovir
keywords: HPV; KTP laser; glottal cancer; glottic cancer; smoking; vocal cord; vocal fold