Presentation
Neck swelling in a heavy smoker.
Patient Data
A huge trans-glottic enhancing lobulated soft tissue ulcerative mass that extends from the base of the tongue to the level of the thyroid gland.
Infiltration of supraglottic ( epiglottis, aryepiglottic fold, false vocal fold, as well as the deep pre-epiglottic and paraglottic space), glottic (both false and true vocal cords bilaterally with the anterior commissure until the level of the arytenoids cartilage), and subglottic(below the true vocal fold to the inferior edge of the cricoid cartilage) regions are noted. Destruction of the hyoid bone, cricoid, thyroid, and arytenoid cartilages also is noted.
Extra-laryngeal spread to the soft tissues of the anterior neck.
Necrotic lymphadenopathy anterior to the left sternocleidomastoid muscle.
Bilateral neck lymphadenopathies.
Case Discussion
The recent patient was a pathology proven case of inoperable squamous cell carcinoma of the larynx stage T4N2 about 5 months ago. Regarding the stage of the mass, tracheostomy and palliative treatments have been done from the time of diagnosis.