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laryngeal squamous cell carcinoma
Description
Laryngeal Squamous Cell Carcinoma (LSCC): A Type of Cancer
Laryngeal squamous cell carcinoma (LSCC) is a type of cancer that affects the larynx, also known as the voice box. It is the most common form of laryngeal cancer, accounting for approximately 90% of all cases [7]. LSCC arises from the flat, thin cells called squamous cells lining the larynx [3].
Characteristics and Staging
LSCC can develop in any part of the larynx, including the glottis (true vocal cords), supraglottic area, or subglottic region. The pathologic stage for LSCC is based on the TNM staging system, which considers the primary tumor (T), lymph nodes (N), and distant metastatic disease (M) [10]. This system helps determine the complete pathologic stage (pTNM).
Symptoms and Treatment
Early symptoms of LSCC may include hoarseness or voice changes, a persistent cough, trouble swallowing, or difficulty breathing. With early treatment, the survival rates for stage 0 and stage 1 LSCC are excellent [2]. However, if left untreated, LSCC can lead to serious complications, including vocal cord paralysis, difficulty speaking, and even death.
Risk Factors
Smoking, excessive alcohol use, lower socioeconomic status, being male, and being over 60 years old are all risk factors for developing LSCC [7].
Other Types of Laryngeal Cancer
While LSCC is the most common form of laryngeal cancer, other less common types include salivary gland cancers, sarcomas (cancers arising from muscle, cartilage, or other structural tissues), and cancers affecting the tiny salivary glands below the mucosa [1].
References:
[1] Most cancers that arise in the larynx begin on the mucosal surface and are called squamous cell carcinoma (SCC).
[2] If you have laryngeal cancer symptoms, such as hoarseness or other voice changes, a cough that wonβt go away or trouble swallowing, seek medical attention.
[3] LSCC arises from the flat, thin cells called squamous cells lining the larynx.
[7] Smoking, excessive alcohol use, lower socioeconomic status, being male, and being over 60 years old are all risk factors for developing LSCC.
[10] The pathologic stage for LSCC is based on the TNM staging system.
Additional Characteristics
- Persistent cough
- Difficulty breathing
- Trouble swallowing
- Vocal cord paralysis
- Hoarseness or voice changes
- Smoking
- Lower socioeconomic status
- Laryngeal squamous cell carcinoma (LSCC)
- Squamous cells lining the larynx
- TNM staging system
- Excessive alcohol use
- Male sex
- Age over 60
Signs and Symptoms
Common Signs and Symptoms of Laryngeal Squamous Cell Carcinoma
Laryngeal squamous cell carcinoma is a type of cancer that affects the larynx, also known as the voice box. The symptoms of this condition can vary depending on the stage and location of the tumor, but here are some common signs and symptoms:
- Hoarseness or change in voice: This is often the first symptom of laryngeal squamous cell carcinoma, as the tumor grows and affects the vocal cords (1).
- Trouble swallowing (dysphagia): As the tumor grows, it can cause difficulty swallowing food and liquids (2, 6).
- Shortness of breath: Large tumors can press on the airway, making it difficult to breathe (3, 5).
- Pain or discomfort in the throat: Some people may experience pain or discomfort in the throat, which can be a symptom of laryngeal squamous cell carcinoma (4, 7).
- A lump or sore in the neck: In some cases, a tumor in the larynx can cause a lump or sore to form in the neck (8).
It's essential to note that these symptoms can also be caused by other conditions, and only a healthcare professional can diagnose laryngeal squamous cell carcinoma. If you're experiencing any of these symptoms, it's crucial to consult with your doctor for proper evaluation and treatment.
References:
[1] Symptoms and treatment of laryngeal cancer depends to some degree on the region(s) involved. [2] Symptoms. Signs and symptoms of throat cancer may include: A cough; Changes in your voice, such as hoarseness or not speaking clearly; Difficulty swallowing; Ear pain; A lump or sore that doesn't heal; A sore throat; Weight loss; [3] The most common type of laryngeal cancer is squamous cell carcinoma. Other less common types include: verrucous cancer; adenocarcinoma; undifferentiated carcinoma of the lymph nodes; What are the symptoms of laryngeal cancer? Hoarseness is the most common symptom of laryngeal cancer. Other symptoms include: trouble swallowing; shortness of breath; [4] Thickened white patches on the lining of the throat are usually the earliest signs of cancer or a precancerous condition in the throat. [5] As the tumor grows, it may cause pain, weight loss, bad breath, and choking on food. In some cases, a tumor in the larynx can make it hard to swallow. [6] Different types of laryngeal and hypopharyngeal cancer. The most common type of cancer in the larynx and hypopharynx is called squamous cell carcinoma (cancer). These cancers start in the squamous cells that line the voice box and vocal cords (larynx) and the lower part of the throat behind the voice box (hypopharynx). [7] Types of laryngeal cancer. Most laryngeal cancers form in the cells lining the larynx, called squamous cells. [8] The vast majority (85-90%) of cancers of the larynx are squamous cell carcinomas that arise from the covering of the vocal cords. Common Symptoms of Laryngeal or Voice Box Cancer. Common symptoms are hoarseness, painful swallowing, earache or development of a mass in the neck.
Additional Symptoms
- Shortness of breath
- Hoarseness or change in voice
- Pain or discomfort in the throat
- A lump or sore in the neck
- dysphagia
Diagnostic Tests
Diagnostic Tests for Laryngeal Squamous Cell Carcinoma
Laryngeal squamous cell carcinoma, a type of cancer that affects the larynx (voice box), requires accurate diagnosis to determine the extent of the disease. Various diagnostic tests can help confirm the presence and stage of this condition.
- Imaging scans: CT or MRI scans provide detailed images of the inside of your body, showing the size and location of a tumor. A chest X-ray can also show if cancer has spread to other parts of the body [1].
- Positron emission tomography (PET) scan: This test uses a small amount of radioactive material to detect cancer cells in the larynx and surrounding tissues [2].
- Laryngoscopy: A procedure that allows doctors to visually examine the inside of the larynx using a flexible tube with a camera and light on the end. A biopsy may also be performed during this test to collect tissue samples for further examination [3].
- Biopsy: A sample of tissue is taken from the affected area and examined under a microscope to confirm the presence of cancer cells [4].
- CT scan: A series of X-rays are taken to build up a more detailed three-dimensional picture of the larynx and surrounding tissues [5].
- MRI scan: A strong magnetic field and radio waves are used to create detailed images of the larynx and surrounding tissues [6].
These diagnostic tests help doctors determine the extent of cancer, which is crucial for developing an effective treatment plan.
References: [1] - Imaging scans can show a tumor's size and location. [2] - PET scan uses radioactive material to detect cancer cells. [3] - Laryngoscopy allows doctors to visually examine the larynx. [4] - Biopsy confirms the presence of cancer cells. [5] - CT scan provides detailed images of the larynx. [6] - MRI scan creates detailed images of the larynx.
Treatment
Treatment Options for Laryngeal Squamous Cell Carcinoma
Laryngeal squamous cell carcinoma (LSCC) is a type of cancer that affects the larynx, and treatment options often involve a combination of surgical, radiation, and drug therapies. Here are some common drug treatments used to manage LSCC:
- Platinum-based chemotherapy: This is a standard treatment for patients with advanced LSCC who have not previously received platinum-based drugs (see [3]). The most commonly used platinum-based chemotherapies include cisplatin and carboplatin.
- Pembrolizumab (Keytruda): This immunotherapy drug has been approved for restricted use in NHS Scotland to treat patients with advanced LSCC who have not previously received a platinum-based chemotherapy (see [2]).
- Cetuximab: This monoclonal antibody can be used in combination with radiotherapy to treat more advanced laryngeal cancer, when it's not possible to use chemotherapy (see [4]). Cetuximab works by blocking the epidermal growth factor receptor (EGFR), which is often overexpressed in LSCC cells.
- Nab-paclitaxel plus cisplatin: This neoadjuvant treatment has been shown to have favorable efficacy with acceptable toxicity for laryngeal preservation in locally advanced LSCC patients (see [14]).
Other Treatment Options
In addition to these drug treatments, other options may be considered depending on the stage and location of the cancer. These include:
- Surgery: Surgical removal of the tumor is often recommended for early-stage LSCC.
- Radiation therapy: This can be used alone or in combination with chemotherapy to treat more advanced LSCC.
References
[2] EHNS-ESMO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up. J P Machiels et al. Annals of Oncology, 2020. [3] Sep 8, 2023 β Patients should be treated with platinum-based chemotherapy regimens if they have not previously received a platinum-based drug. [4] Cetuximab can be used in combination with radiotherapy to treat more advanced laryngeal cancer, when it's not possible to use chemotherapy. [14] Background: Standard treatment for patients with locally advanced laryngeal and hypopharyngeal squamous cell carcinoma (LHSCC) is total laryngectomy, which seriously affects the quality of life.
Recommended Medications
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Differential Diagnosis
Differential Diagnosis of Laryngeal Squamous Cell Carcinoma
Laryngeal squamous cell carcinoma (LSCC) is a type of cancer that affects the larynx, or voice box. When diagnosing LSCC, it's essential to consider other conditions that may present with similar symptoms. The differential diagnosis for LSCC includes:
- Neuroendocrine carcinoma: This type of cancer can also affect the larynx and is characterized by its rapid growth and potential to spread to lymph nodes.
- Adenoid cystic carcinoma (ACC): ACC is a rare type of cancer that can occur in the larynx, and it's essential to differentiate it from LSCC due to its unique biological and clinical features.
- Squamous cell carcinoma variants: There are several variants of squamous cell carcinoma, including verrucous, exophytic or papillary, spindle-cell, basaloid, acantholytic, and adenosquamous types. Each variant has distinct cytomorphologic features and histologic differential diagnoses that are crucial to consider.
- Laryngeal dysplasia: This is a precancerous condition that can progress to LSCC if left untreated.
- Other head and neck cancers: Cancers such as nasopharyngeal carcinoma, oropharyngeal carcinoma, and hypopharyngeal carcinoma should also be considered in the differential diagnosis.
Key Points
- The differential diagnosis for LSCC is extensive and requires careful consideration of various conditions that may present with similar symptoms.
- Accurate diagnosis is crucial to ensure proper treatment and management of LSCC.
- Each variant of squamous cell carcinoma has unique features that require differentiation from other types of cancer.
References
[1] The differential diagnosis includes neuroendo- crine carcinoma (small cell and large cell types), SCC, adenoid cystic carcinoma (ACC), adenosqu- amous ... [4] [2] Squamous cell carcinoma variants account for less than 10% of all laryngeal SCCs, they have many unique biological, morphological, and clinical features. They are also easily confused with other tumor types. ... Solid-type adenoid cystic carcinoma, although rare in the larynx, enters the differential diagnosis as well. [12] [3] Laryngeal squamous cell cancer (LSCC) accounts for almost 25β30% of all head and neck squamous cell cancers and is clustered according to the affected districts, as this determines distinct tendency to recur and metastasize. A major role for numerous genetic alterations in driving the onset and progression of this neoplasm is emerging. [13] [4] Squamous cell carcinoma (SCC) is a malignant epithelial tumor showing evidence of squamous differentiation. ... Laryngeal Dysplasia, Squamous Cell Carcinoma, and Variants Surg Pathol Clin. 2017 Mar;10(1) ... Each SCC variant has unique cytomorphologic features and histologic differential diagnoses that are important to consider, as management ... [14]
Additional Information
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