Spread of Carcinoma Larynx
Carcinoma larynx spreads by:
- Local extension
- Spread through laryngeal spaces
- Lymphatic spread
- Cartilage invasion
- Distant metastasis
Supraglottic Carcinoma
May spread to:
- vallecula
- base of tongue
- pyriform fossa
- aryepiglottic folds
Frequently invades:
- pre-epiglottic space
- paraglottic space
Glottic Carcinoma
Usually begins on one vocal cord.
Routes of Spread
- anterior commissure
- opposite vocal cord
- arytenoid region
- ventricle
- subglottis
Cord fixation suggests deep infiltration.
Subglottic Carcinoma
May spread:
- circumferentially
- inferiorly into trachea
- upward into vocal cords
Advanced lesions may invade:
- cricoid cartilage
- thyroid gland
- strap muscles
Lymphatic Spread
Supraglottis
Early nodal metastasis common.
Glottis
Minimal lymphatics. Early nodal spread uncommon.
Subglottis
May spread to pretracheal and mediastinal nodes.
Distant Metastasis
Common sites:
- lungs
- liver
- bone