Larynx and hypopharynx
Squamous cell carcinoma
General

Author: Nat Pernick, M.D. (see Authors page)

Revised: 22 March 2018, last major update November 2013

Copyright: (c) 2002-2018, PathologyOutlines.com, Inc.

PubMed Search: Squamous cell carcinoma [title] larynx [title] pathology

Cite this page: Pernick, N. Squamous cell carcinoma - general. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/larynxcarcinomageneral.html. Accessed July 17th, 2018.
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
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
  • Nodal metastasis occurring post radiation therapy with mixture of squamous cell carcinoma and rhabdomyosarcoma (Am J Surg Pathol 1993;17:415)
Clinical images

Images hosted on PathOut server:

Contributed by Dr. Steven Catinchi-Jaime:
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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
Microscopic (histologic) images

Images hosted on PathOut server:

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


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Various images


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Alpha-1-antichymotrypsin

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Vimentin

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CD68

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Cytokeratin AE1/AE3

Positive stains
Additional references