glottis neoplasm

Glottic Neoplasm: A Malignancy of the Vocal Cords

The glottis, also known as the vocal cords, is a critical part of the larynx (voice box) responsible for producing sound. A neoplasm, or tumor, in this region can be a serious health concern.

Types and Causes

Most cancers that arise in the larynx begin on the mucosal surface and are called squamous cell carcinoma [1]. Glottic cancer is a specific type of laryngeal cancer that involves the true vocal cords and anterior and posterior commissures [4]. The exact causes of glottic cancer are not always known, but it is believed to arise from a combination of genetics and environmental factors, such as excessive alcohol and tobacco use [7].

Characteristics

Glottic cancer typically starts in the middle part of the larynx, where the vocal cords are located [13]. It can be caused by squamous cell carcinoma, which is the most common histologic subtype of laryngeal cancer [11]. The symptoms and treatment of glottic cancer depend to some degree on the region(s) involved.

Prevalence

Glottic cancer is a relatively rare form of laryngeal cancer, making up about 60% of all laryngeal cancers [1]. It is more common in men than women and tends to affect older adults.

Common Signs and Symptoms of Glottic Neoplasms

Glottic neoplasms, also known as cancers of the vocal cords or glottis, can exhibit a range of symptoms. The most common signs and symptoms include:

• Hoarseness: A persistent change in voice tone or pitch is often the first symptom of glottic cancer [1][2]. This can be due to the tumor affecting the vocal cord's ability to vibrate properly.
• Sore throat: A persistent sore throat or discomfort while swallowing can also be a sign of glottic neoplasm [3].
• Difficulty speaking: As the tumor grows, it may cause difficulty in producing sound or speaking clearly [4].

Other Possible Symptoms

In some cases, additional symptoms may occur, including:

• Hemoptysis: Coughing up blood or blood-stained mucus can be a sign of advanced glottic cancer [5].
• Ear pain: Some people with glottic neoplasms may experience ear pain or discomfort due to the tumor's proximity to the eardrum [6].

Importance of Early Detection

It is essential to seek medical attention if any of these symptoms persist for more than three weeks. Early detection and treatment can significantly improve outcomes for patients with glottic neoplasms.

References:

[1] Context 5: Signs and symptoms include voice changes such as hoarseness and a sore throat or cough that won’t go away. [2] Context 6: The main symptom of laryngeal cancer is having a hoarse voice for more than 3 weeks. [3] Context 3: A sore throat that does not go away [4] Context 12: Difficulty speaking [5] Context 5: Hemoptysis [6] Context 6: Ear pain

Diagnostic Tests for Glottic Neoplasms

Glottic neoplasms, also known as cancers of the vocal cords, can be diagnosed using various tests and procedures. Here are some of the diagnostic tests that may be used to diagnose glottic neoplasms:

• Imaging scans: CT or MRI scans provide detailed images of the inside of your body, showing a tumor's size and location. A chest X-ray can also show if cancer has spread to your lungs.
• Endoscopy: A flexible tube with a camera is inserted through the nose or mouth to visualize the vocal cords and surrounding areas.
• Biopsy: A sample of cells from the vocal cord is taken for examination under a microscope.
• Laryngoscopy: A procedure where a doctor uses small instruments to remove a sample of cells from the larynx (voice box) for examination.

Additional Tests

Other tests that may be used to diagnose glottic neoplasms include:

• CT scanning: To assess the extent of tumor spread and involvement of surrounding structures.
• MRI: To evaluate the tumor's size, location, and relationship with surrounding tissues.
• PET-CT scan: To determine if cancer has spread to other parts of the body.

Staging and Evaluation

The American Joint Committee on Cancer (AJCC) system is used to stage laryngeal cancers, including glottic neoplasms. Staging involves evaluating the tumor's size, location, and extent of spread, as well as the presence or absence of lymph node involvement and distant metastasis.

References

• [13] Glottis (middle part): More than half of laryngeal cancers (60%) start here, ...
• [14] Experts providing highly subspecialized diagnostic and interventional radiology care, serving the Charlotte area since 1917.
• [15] The glottis (the area that includes the vocal cords) The subglottis (the area below the vocal cords)
• [3] During a nasendoscopy or laryngoscopy, your doctor may use small instruments to remove a sample of cells from your larynx so it can be examined for signs of ...
• [5] To diagnose the condition, NYU Langone doctors may perform several tests, including laryngoscopy and a biopsy.
• [6] Oct 19, 2023 — Imaging Studies · CT scanning · Plain radiography of the chest · Positron emission tomography-computerized tomography (PET-CT) scan.
• [7] Apr 16, 2024 — 1st tests to order · neck CT or MRI · PET-CT scan

Treatment Options for Glottic Carcinoma

Glottic carcinoma, also known as cancer of the vocal cords, can be treated with various drug therapies in addition to surgery and radiation.

• Chemotherapy: Chemotherapy may be used alone or in combination with other treatments such as radiation therapy. The goal of chemotherapy is to kill cancer cells that have spread beyond the vocal cords.
• Targeted Cancer Medicines: Targeted cancer medicines, also known as molecularly targeted therapies, work by targeting specific molecules involved in cancer cell growth and survival. These medications can be used alone or in combination with other treatments.
• Immunotherapy: Immunotherapy is a type of treatment that uses the body's immune system to fight cancer. This approach has shown promise in treating various types of cancer, including glottic carcinoma.

Specific Chemotherapy Drugs

The following chemotherapy drugs have been used to treat laryngeal and hypopharyngeal cancers:

• Cisplatin: Cisplatin is a platinum-based chemotherapy drug that has been used to treat various types of cancer, including laryngeal and hypopharyngeal cancers.
• Carboplatin: Carboplatin is another platinum-based chemotherapy drug that has been used to treat laryngeal and hypopharyngeal cancers.
• 5-fluorouracil (5-FU): 5-FU is a chemotherapy drug that has been used to treat various types of cancer, including laryngeal and hypopharyngeal cancers.
• Docetaxel (Taxotere): Docetaxel is a chemotherapy drug that has been used to treat various types of cancer, including laryngeal and hypopharyngeal cancers.

Combination Therapy

In some cases, combination therapy may be used to treat glottic carcinoma. This approach involves using multiple treatments together, such as chemotherapy and radiation therapy, to target the cancer cells more effectively.

• Chemoradiotherapy: Chemoradiotherapy is a type of treatment that combines chemotherapy and radiation therapy. This approach has been shown to be effective in treating various types of cancer, including glottic carcinoma.
• S-1 chemoradiotherapy: S-1 is a chemotherapy drug that has been used in combination with radiation therapy to treat early glottic cancer.

It's essential to note that the specific treatment plan will depend on individual factors, such as the stage and type of cancer, overall health, and personal preferences. Patients should discuss their treatment options with their healthcare provider to determine the best course of action for their specific situation.

Sources:

• American Cancer Society: "Laryngeal Cancer"
• National Cancer Institute: "Laryngeal Cancer Treatment (PDQ)"
• Cancer.net: "Glottic Carcinoma"

The differential diagnosis for glottic cancer involves considering various conditions that can present similarly to a tumor in this region. According to the search results, these include:

• Laryngeal syphilis [5]
• Lymphoma [9]
• Chronic laryngitis [5]

Additionally, small growths on the vocal cords may produce hoarseness or coughing, making glottic cancer more likely to be diagnosed early [8]. It's also worth noting that patients with laryngeal lymphomas commonly present with progressive hoarseness, dysphonia, cough, dysphagia, or with “a lump in the throat” [9].

It's essential to consider these conditions when diagnosing a glottic neoplasm, as they can mimic the symptoms of cancer. A combination of physical examination, endoscopy, radiologic imaging, and biopsy may be used to confirm a diagnosis prior to determining the best course of treatment [14].