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Supraglottic SCC- Differential Diagnoses

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Hello everyone.

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Dr. Sidney Levy here continuing our discussion

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of laryngeal squamous cell malignancy.

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We were talking about supraglottic tumors and I would

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like to round that off by mentioning some of the

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differential diagnoses of lesions in this region.

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Firstly, one of the challenges that

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head and neck radiologists often face

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is deciding whether a tumor originates

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or the piriform sinus, or the post cricoid space.

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And that can be difficult, especially when

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normal anatomical structures have been effaced.

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But as a general rule, it's worth remembering

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that, firstly, regarding the areoepiglottic

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folds, which we have here, although they're

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quite abnormal, a supraglottic tumor will

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tend to be centered medial

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to the center of the areoepiglottic

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fold, whereas a piriform sinus tumor

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will tend to be centered laterally.

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And it's just worth remembering that the lateral

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wall of the areoepiglottic fold is considered part

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of the piriform sinus, whereas the medial wall

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is considered part of the supraglottic larynx.

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So, you just need to make a judgment as

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to where you think the tumor is centered.

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Post cricoid space tumors tend to be a little bit

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further down and a little bit more medial as well.

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They're often midline tumors, most of the time.

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Other differentials in this region might

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include adenoid cystic carcinoma or

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other minor salivary gland malignancy.

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But this is usually a diagnosis made

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retrospectively with the help of a pathologist.

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And occasionally, you may see autoimmune conditions

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such as rheumatoid arthritis or sarcoidosis which

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can mimic a tumor in the supraglottic region.

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Rarely, you may see the sequelae or consequences

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of gastroesophageal reflux disease in this area.

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A laryngocele is usually readily

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distinguishable by being either a fluid or

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air filled cystic structure in the area.

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But remember, a laryngocele

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can also occur with a tumor.

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So, just because you see a structure that looks like

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a laryngocele, you need to look very carefully to

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make sure that there isn't an associated mass lesion.

Report

Description

Faculty

Sidney Levy, PhD, MBBS

Radiologist and Nuclear Medicine Specialist

I-MED

Tags

Non-infectious Inflammatory

Neuroradiology

Neuro

Neoplastic

MRI

Larynx

Infectious

Head and Neck