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Chapter: Surgical Pathology Dissection : Larynx

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Important Issues to Address in Your Surgical Pathology Report on the Larynx

What procedure was performed, and what structures/organs are present?

Important Issues to Address in Your Surgical Pathology Report on the Larynx*

General

·         What procedure was performed, and what structures/organs are present?

·            What is the exact location of the tumor? Specifically, what is the probable site of tumor origin (glottis, supraglottis, subglottis), and what compartments and structures (e.g., glottis, supraglottis, subglottis, hypopharynx, pre-epiglottic space, thyroid cartilage) does it involve by direct extension? Does the tumor cross the midline to involve both sides of the larynx?

·            What are the tumor’s size, grade, type, and growth pattern (exophytic or endophytic)? What is the depth of deepest tumor invasion?

·            Is there perineural and/or vascular invasion?

·   Are any soft tissue or mucosal margins in-volved?

Supraglottic Cancers

·   If the hyoid bone is attached, is the tumor above or below the level of the hyoid?

·   Does the tumor involve the false cord, the epiglottis, the aryepiglottic folds, and/or the arytenoids?

·   Does the inferior edge of the tumor involve the anterior commissure and/or the roof of the ventricle?

·   If the aryepiglottic fold is involved, how far down the pyriform sinus does the tumor extend?

·   How far does the cancer extend superiorly toward the base of the tongue?

·   Does the cancer involve the pre-epiglottic space?

·   Does the tumor invade the cartilaginous framework?

Glottic Cancers

·   Does the tumor involve one vocal cord or both, and what is the length of the cord involvement? 

·   Is the anterior commissure involved? If so, does the tumor extend anteriorly into the thyroid cartilage?

·   How far inferiorly below the free edge of the true vocal cords does the tumor extend (in millimeters)?

·   Does the tumor extend superiorly into the ven-tricle, false cord, or base of the epiglottis?

·   Does the cancer involve the paraglottic space?

Subglottic Cancers

·   What is the superior extent of the tumor? Does it involve the true vocal cord?

·   What is the inferior extent of the tumor? How close is the tumor to the inferior margin?

·            What is the maximal depth of invasion? Does the carcinoma penetrate the conus elasticus and extend into the paraglottic space?

 

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