Glottic cancer - stage cT1a

Case contributed by Dr Maria Grazia Papi

Presentation

Neck pain, hoarseness. Laryngoscopic results: both vocal cords with preserved mobility; thickening and irregular bulging of the Left true vocal cord. Biopsy was performed

Patient Data

Age: 80 years
Gender: Male
CT

Irregular thickening of the free edge of the left true vocal cord, with preserved para-glottic space.

Annotated image

Irregular bulging of the free edge of the left vocal cord (white arrow).

Preserved fat hypodensity of the paraglottic space (black arrowhead).

Pathology

Histopathological diagnosis (translation from the original paper):

Incisional biopsy specimen from within the left true vocal cord.

Results: multiple fragments of about 10 mm maximum diameter resulting of invasive squamous carcinoma of high grade (G3).

Case Discussion

This is a retrospective study and CT imaging was compared to histopathological diagnosis.

According to AJCC prognostic stage grouping 2018, this primary tumor of glottic was considered T1a and stage I because the tumor invaded only one vocal cord with normal mobility.

CT study confirmed the laryngoscopic assessment; there was a good correlation between vocal cord preserved mobility at laryngoscopy and PGS-sparing on the CT; moreover, good correlation of the neoplastic extension in the axial plane with both modalities resulted.

If there had been both vocal cords involvement with normal mobility and PGS sparing at CT scan,  a T1b stage would result.

Radiotherapy planning was considered.

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