The Journal of Laryngology & Otology

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Submucosal neoplasms of the laryngeal introitus

A D Friedmana1 c1, J A Burnsa1, M J Lutcha2 and S M Zeitelsa1

a1 Department of Surgery, Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts, USA

a2 Department of Otolaryngology, Southern California Permanente Medical Group, San Diego, California, USA


Background: The differential diagnosis of endolaryngeal mesenchymal neoplasms includes a wide spectrum of benign and malignant pathologies, which have been rarely photo-documented and assessed as a group.

Methods: Non-epithelial neoplasms of the endolarynx seen at our centre from 2002 to 2011 (n = 38; 36 treated at our institution) were retrospectively reviewed, with attention to clinical presentation, radiographic imaging, operative management, histology, and pre- and post-operative endoscopy. Submucosal squamous cell carcinomas, mucosal cysts, amyloid and Teflon granulomas were excluded.

Results: Twenty-three of a total of 36 patients underwent definitive endoscopic surgical treatment. Supraglottic pathologies included lymphoma, lipoma, neuroendocrine carcinoma, lymphangioma, oncocytoma, haemangioma, synovial cell sarcoma and benign spindle cell neoplasm. Transglottic pathologies included synovial cell sarcoma and granular cell tumour. Glottic pathologies included granular cell tumour, osteoma, rhabdomyoma, rhabdomycosarcoma and myofibroblastic sarcoma. Subglottic pathologies included chondrosarcoma, neurofibroma, adenoid cystic carcinoma and vascular malformation.

Conclusion: The site of origin, degree of malignant behaviour and sensitivity to adjuvant treatment determined the course of surgical management, i.e. endolaryngeal versus transcervical, and limited removal versus wider resection.

(Accepted October 21 2011)

(Online publication May 25 2012)


c1 Address for correspondence: Dr Aaron D Friedman, Massachusetts General Hospital, Center for Laryngeal Surgery and Voice Rehabilitation, One Bowdoin Square, 11th Floor, Boston, MA 02114, USA Fax: +1 617 726 0222 E-mail:


Presented as a poster at the Eastern Section Meeting of the Triological Society, 23–25 January 2009, Boston, Massachusetts, USA

Dr A D Friedman takes responsibility for the integrity of the content of the paper

Competing interests: None declared