Larynx, hypopharynx & trachea
Squamous cell carcinoma
Conventional squamous cell carcinoma


Topic Completed: 1 November 2013

Minor changes: 27 July 2020

Copyright: 2002-2019, PathologyOutlines.com, Inc.

PubMed Search: Squamous cell carcinoma [title] larynx [title] pathology "loattrfree full text"[sb]

Nat Pernick, M.D.
Adriana Handra-Luca, M.D.
Page views in 2019: 5,614
Page views in 2020 to date: 3,704
Cite this page: Pernick N, Handra-Luca A. Conventional squamous cell carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/larynxcarcinomageneral.html. Accessed August 10th, 2020.
Definition / general
  • 9,000 new cases annually in US; 40% mortality
  • Represents 90% of all laryngeal cancers
  • 96% male; usually ages 40+ (but can occur in younger patients)
  • Major risk factors are smoking, enhanced by heavy alcohol consumption
  • HPV is not an early factor but positive in 20%, usually HPV 16 (Hum Pathol 1999;30:274)
  • EBV a factor in 40% of hypopharyngeal carcinomas (Hum Pathol 1999;30:1071)
  • Site influences histology and clinical behavior - either glottic, supraglottic or transglottic
  • Spread is limited by tough membranes / ligaments
  • Recurrence rate of 3% per year, second primary rate is 5% per year, usually in lung
  • Metastases to regional lymph nodes and lungs; direct extension to thyroid gland and jugular vein
Clinical features
Prognostic factors
  • TNM; also tumor grade, tumor size, mitotic count, vascular invasion and margins

  • 5 year survival by site:
    • Glottic: I: 90%; II: 85%; III: 60%; IV: < 5%
    • Supraglottic: I: 85%; II: 75%; III: 45%; IV: < 5%
    • Transglottic: 50%
    • Subglottic: 40%
Case reports
Treatment
Clinical images

Contributed by Dr. Steven Catinchi-Jaime
Missing Image Missing Image

Malignant fibrous histiocytoma and squamous cell carcinoma arising in a vocal chord

Gross description
  • Pink to gray ulcerated mass; vocal cord lesions often keratotic
Microscopic (histologic) description
  • Invasion indicated by desmoplasia around malignant squamous cells, often with keratinization at periphery
  • Progression of columnar epithelium areas is similar to squamous cell carcinoma of cervical or lung
  • Progression of vocal cord tumors is similar to squamous cell carcinoma of skin or esophagus
  • Well, moderate or poorly differentiated, based on degree of keratinization, pearl formation, intercellular bridges and mitotic activity
  • Smaller tumors are usually better differentiated
  • Trachea:
    • Variants include spindle cell, sarcomatoid
    • May arise in papilloma
    • May be combined with small cell and giant cell carcinoma
Microscopic (histologic) images

Contributed by Dr. Steven Catinchi-Jaime - malignant fibrous histiocytoma and squamous cell carcinoma arising in a vocal chord
Missing Image Missing Image Missing Image Missing Image Missing Image

Various images


Missing Image Missing Image Missing Image Missing Image

Various images


Missing Image

Alpha-1-antichymotrypsin

Missing Image

Vimentin

Missing Image

CD68

Missing Image

Cytokeratin AE1 / AE3



Images hosted on other servers:

Basaloid squamous cell carcinoma

Various images

Positive stains
Additional references
Back to top