Introduction
Laryngeal verrucous carcinoma (LVC) is an uncommon form of well-differentiated squamous cell carcinoma of the larynx, typified by warty growths that invade the tissue locally. It represents one percent to three percent of laryngeal carcinoma cases and is an uncommon, locally invasive tumor. It is considered one form of squamous cell carcinoma that grows slowly, is locally invasive, and is a well-differentiated tumor. Usually, it originates from the larynx's surface epithelium, specifically the voice cords and supraglottic areas.
What Part of the Larynx Does Laryngeal Verrucous Carcinoma Commonly Affect?
Laryngeal verrucous carcinoma is the most prevalent in the glottis (74.0 percent). It is considered the site of genesis for laryngeal verrucous carcinoma (LVC), with the supraglottis (9.2 percent) and subglottis less typically impacted. It usually appears as a projecting, wart-like growth when seen graphically. The glottic area of the larynx is typically the most affected.
Who Is at Risk for Laryngeal Verrucous Carcinoma?
It is generally more common in men when compared to women. It is seen in individuals with a history of
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Smoking: One of the main risk factors is prolonged tobacco smoke exposure, which can lead to cellular alterations and genetic abnormalities in the laryngeal epithelium.
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Drinking of Alcohol: Excessive alcohol intake, particularly when paired with smoking, raises the risk of laryngeal cancer by compromising epithelial barriers and reducing mucociliary clearance.
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Infection With the Human Papillomavirus (HPV): High-risk HPV strains such as HPV-16 and HPV-18 have the ability to integrate into the host genome and disrupt oncogene expression and cell cycle regulation.
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Other Factors: Radiation, industrial chemicals, asbestos, and inadequate dental hygiene are possible environmental exposures linked to laryngeal verrucous cancer.
What Are the Symptoms of Laryngeal Verrucous Carcinoma?
The following are the symptoms of Laryngeal verrucous carcinoma
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Hoarseness: The most common early symptom of laryngeal verrucous cancer is voice change or hoarseness. This happens as a result of the tumor's interference with the vocal cords, which alters voice quality and interferes with normal function.
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Dyspnea or Trouble Breathing: Breathing difficulties or shortness of breath, referred to as dyspnea, can result from an airway obstruction caused by the growing or spreading tumor. When the tumor grows, this symptom may worsen gradually or rapidly if it suddenly obstructs the airway.
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Dysphagia or Trouble Swallowing: Another symptom of laryngeal verrucous cancer is dysphagia, or trouble swallowing. Eating or drinking can be painful or uncomfortable due to the tumor's interference with normal swallowing function.
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Obstruction of the Upper Airway: Upper airway obstruction can arise from laryngeal verrucous cancer in its later stages, which can cause partial or total blockage of the upper airway. Serious breathing problems, stridor (noisy breathing), or even respiratory distress may result, necessitating immediate medical intervention.
How to Diagnose Laryngeal Verrucous Carcinoma?
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Physical Examination: The lesion or tumor is located by a physical examination performed by the healthcare provider. In addition, they inquire about the lifestyle, medical history, and symptoms, including any tobacco use or smoking. The direct visualization of the laryngeal mucosa during flexible laryngoscopy enables the identification of suspicious lesions.
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Imaging: Magnetic resonance imaging (MRI) and computed tomography (CT) scans offer comprehensive anatomical details regarding the tumor's location, size, and extent. These imaging methods support treatment planning by evaluating how much the tumor has affected nearby structures.
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Biopsy: A biopsy is required to make a conclusive diagnosis of laryngeal verrucous cancer. A pathologist will use a microscope to evaluate a small tissue sample taken from the larynx's worrisome lesion during this surgery. The characteristics of well-differentiated squamous cell carcinoma with pushing margins and little cytologic atypia are revealed by histopathological investigation.
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Staging: The TNM (tumor, node, metastasis) classification system is used to identify the stage of laryngeal verrucous carcinoma after a diagnosis. This approach evaluates the size of the original tumor, involvement of regional lymph nodes, and presence of distant metastases. This stage aids prognostic evaluation and treatment choices.
What Is the Differential Diagnosis of Laryngeal Verrucous Carcinoma?
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Papilloma: A benign (non-cancerous) tumor that originates from the epithelial surface and typically grows outward.
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Papillomatosis: A rare condition in which the respiratory tract develops small tiny growths that resemble warts.
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Pseudoepitheliomatous Hyperplasia: It is a reactive growth of epithelial cells that occurs in reaction to many different diseases, including infections, neoplasia, inflammation, and trauma.
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Well Differentiated Squamous Cell Carcinoma: The most common type of skin cancer caused by exposure to ultraviolet light.
How Is Laryngeal Verrucous Carcinoma Treated?
Healthcare providers generally provide the following treatment options:
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Surgical Intervention: The mainstay of treatment for laryngeal verrucous cancer is surgery. The majority of patients have primary surgical therapy; depending on the size, location, and degree of tumor dissemination, this may entail open surgeries or local excision. Transoral laser microsurgery (TLM) is a minimally invasive technique for local excision that can produce outstanding results, such as good laryngeal preservation rates and low recurrence rates.
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Radiation Therapy: Adjuvant radiation may be utilized when surgical resection alone is neither practical nor sufficient. Although there has previously been a reluctance to undergo radiation therapy because of worries about anaplastic transformation, new research indicates that this risk is minimal. Patients with recurring diseases or who are not the best candidates for surgery may benefit most from radiotherapy. Several variables, including tumor characteristics, patient preferences, comorbidities, and functional results, influence the decision between surgery and radiation treatment. Radiotherapy is still a good option, even though surgery has historically produced better overall and disease-free survival rates. This is especially true for individuals who cannot have surgery or recurring diseases.
What Is the Prognosis of Laryngeal Verrucous Carcinoma?
Most patients with laryngeal verrucous carcinoma have a favorable prognosis. Consult the physician and adhere to the prescribed course of action. Avoid tobacco products and consume alcohol in moderation for a better prognosis.
Conclusion
Laryngeal verrucous carcinoma is a highly treatable cancer. By abstaining from alcohol and tobacco use, one can lower the chance of getting this cancer. If one discovers symptoms such as dyspnea, hoarseness of voice, dysphagia, and obstruction of the airway, get in touch with a healthcare professional. Early diagnosis allows for earlier treatment and a quicker recovery.
