Supraglottic squamous cell carcinoma

Case contributed by Smita Deb
Diagnosis almost certain

Presentation

Palpable bilateral lymphadenopathy. Lifelong heavy smoker.

Patient Data

Age: 70 years
Gender: Male

• Midline supraglottic mass in the right deep epiglottic fat (19.6 x 22.4 x 38mm).

• Glottic and anterior commissure involvement.

• Destruction of anterior thyroid cartilage left of midline.

• Necrotic lymph node right level 3 (13x23mm).

  • Midline supraglottic mass in the right deep epiglottic fat
  • Invasion of laryngeal prominence of thyroid cartilages with enhancing tissue breaching thyroid cartilage.
  • Involvement of anterior commissure and left true cord (asymmetrical thickening of cord).
  • No prevertebral soft tissue invasion or involvement of the carotid space.
  • Multiple bilateral lymphadenopathy:
    • Right level III: 20 x 11 mm with necrosis
    • Right level III: 7 mm
    • Left level III: 11 x 9 mm
    • Left Occipital node: 6 mm

Case Discussion

Late stage supraglottic SCC.

Staging based on the system for supraglottic tumors:

  • T4a - invasion of tissues beyond the larynx, in this case, the thyroid cartilage.
  • N2c - metastasis in bilateral lymph nodes <6cm.

Case submitted by Dr Smita Deb and A/Prof Pramit Phal.

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