0:00

So this was a young patient, I think she was on 35 years old,

0:04

that presented with hoarseness and strider.

0:08

So when we look at the larynx,

0:10

what we see is that up at the supraglottic larynx, it looks pretty, pretty good.

0:14

The one thing that's a little concerning is that, you know,

0:17

it's a little bit of dilatation, larygeal ventricles, but that can be normal.

0:21

Once we get down to the true vocal cord, they look pretty well.

0:23

But once we get down to the subglottic larynx,

0:26

we can see there's marked narrowing of the subglottic larynx.

0:30

And when we look at the bone algorithms, what we see here,

0:36

so once we see the narrowing,

0:38

we can see it's actually being caused by this mass right here,

0:41

which is involving the crico cartilage.

0:44

So this narrowing of the larynx is not due to a

0:49

mucosal lesion involving the surface of the larynx,

0:53

but rather it's due to a heterogeneous

0:58

ossified or calcified mass that's originating from the crico

1:02

cartilage. So when you see something like this,

1:05

the diagnosis in the majority of cases is gonna be a chondro sarcoma

1:10

involving the Crico cartilage. So in a way it's a bit of an ant many.

1:14

So let me take any questions there if you, if, if you have any.

1:19

Oh, how they're treated. That's a really good question. Yeah,

1:22

it's a really good question. So it really depends. Uh,

1:26

these can be treated either with nothing and just watched,

1:30

just based on the patient's clinical symptoms.

1:33

I've seen some of those being followed. Um,

1:36

I've also seen some of these being resected and if they do resected though,

1:40

they're gonna have to do a total laryngectomy with, um, a sleeve resection.

1:46

Um, it's a good question.

1:48

I haven't seen that many that are being treated with radiation therapy. Um, uh,

1:52

but I assume radiation therapy could be an option. In general,

1:56

sarcomas don't respond well to radiation therapy. So what I've seen is either,

2:01

uh, resection in order to maintain the integrity of the airway, um, or, um,

2:06

just being followed to make sure they don't rapidly enlarge it. If they do,

2:09

then they'll have to be treated with the total laryngectomy. Han,

2:13

do you have any questions?

2:15

Uh, no. Is it very common?

2:18

Uh, you know, it's always a question of what's common. Um, I would just say,

2:23

I would say it's not necessarily uncommon. I think, uh, um, you know, you,

2:27

you can, you can see these, is it as common as squamous cell carcinoma? Uh, not,

2:32

no, no chance. Uh, but on the other hand, if you, if you look at these, um,

2:36

sometimes you'll see the cartilage can be very interesting. Uh,

2:39

oftentimes when we see these,

2:40

you can see these little subtle abnormalities involving the thyroid cartilage,

2:44

and we typically attribute it to end CDR Romas. So, um, but uh,

2:49

yeah, you'll occasionally see these con sarcomas.