Larynx, hypopharynx & trachea

Other malignancies

Chondrosarcoma



Topic Completed: 1 December 2013

Minor changes: 16 March 2021

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PubMed Search: Chondrosarcoma [title] larynx

Nat Pernick, M.D.
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Cite this page: Pernick N. Chondrosarcoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/larynxchondrosarcoma.html. Accessed December 8th, 2021.
Definition / general
  • 0.5% of primary laryngeal tumors
  • Mean age 64 years, range 25 - 91 years; 80% male
  • 69% arise in cricoid, 9% in thyroid cartilage and 14% in both
  • 18 - 30% recur (more common with higher grade); death usually due to recurrence and not distant metastases
  • 46% are grade I, 49% grade II, 5% grade III
  • 37% have associated chondroma
  • Myxoid and dedifferentiated variants may have worse prognosis; surprisingly, grade may not be associated with clinical outcome
  • Clear cell variants are very rare
Case reports
Treatment
  • Complete excision with sparing of vocal cords
Gross description
  • Usually 3 cm or more, invasion into bone of ossified laryngeal cartilage
Microscopic (histologic) description
  • Diagnostic fields often small; have atypical, neoplastic chondrocytes with loss of normal architecture and distribution and invasion of bone; laryngeal cartilage usually has undergone endochondral ossification
  • Low grade chondrosarcoma: slight increase in cellularity, mild atypia with binucleated chondrocytes within 1 lacuna; difficult to distinguish from chondroma; can report as "cartilaginous tumor without obvious evidence of malignancy, further classification pending removal of entire lesion"
  • High grade chondrosarcoma: hypercellular with enlarged, binucleated and multinucleated atypical cells with increased nuclear to cytoplasmic ratio, irregular nuclear chromatin, prominent nucleoli, mitotic figures (may be atypical) and variable tumor necrosis
  • Dedifferentiated chondrosarcoma: also called chondrosarcoma with additional malignant mesenchymal component (Am J Surg Pathol 1988;12:314)
Positive stains
  • Clear cell variants: S100, collagen type II
Negative stains
Molecular / cytogenetics description
  • Clear cell variants: loss of 9p22 and 18q21
Differential diagnosis
  • Chondroid metaplasia
  • Chondroma
  • Vocal process of arytenoid cartilage (normal finding)
Additional references
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