Chondrosarcoma of Cricoid Cartilage

Presented by Drs. Fauzia Mir,  Myra Malik, and Anil Patel, Royal National Throat, Nose and Ear Hospital, London

This Featured Video accompanies the Featured Case presenting anesthetic and airway management of the patient with chondrosarcoma of cricoid cartilage. You can access the full case presentation here.

Chondrosarcoma is a rare malignant cartilaginous tumor of the larynx, which occurs most often in males. Most of the chondrosarcomas affect the skeletal system (pelvis, femur, humerus, etc.), with only 10-12% of the disease confined to the head and neck.

In the larynx, the tumor predominantly arises from posterolateral region of the cricoid cartilage; less common locations include thyroid cartilage, the arytenoid and epiglottis. The disease is characterized by insidious onset, and patients can remain asymptomatic for a long period of time. Dyspnea and dysphonia are the most common presenting symptoms, and dysphagia may occur secondary to compression of the esophagus.

Computed Tomography (CT) allows to determine the location and extent of cartilaginous tumors, and the degree of laryngeal obstruction, therefore representing the imaging modality of choice. Magnetic Resonance Imaging (MRI) is less specific, but more precise in defining the tumor extension and the involvement of the surrounding structures.

Chondrosarcoma is a low-grade malignant tumor, and the metastatic spread is uncommon. After surgical resection, survival at 10 years exceeds 95% (the main prognostic factors include the histologic grade, location of the tumor, and the extent and quality of the initial resection). Surgery is the treatment of choice, and can range from endoscopic debulking to a total laryngectomy, depending on the extension and histological grade of the tumor.

References.

1.    Chenna H, Berhil H, Toulba H, et al. Laryngeal Chondrosarcoma: A Case Report with Review of Literature. Open Access Scientific Reports 2013. 2: 680. doi:10.4172/ scientificreports.680
2.    Baatenburg de Jong RJ, van Lent S, Hogendoorn PC. Chondroma and chondrosarcoma of the larynx. CurrOpinOtolaryngol Head Neck Surg 2004;12:98-105.
3.    Potochny EM, Huber AR. Laryngeal Chondrosarcoma. Head Neck Pathol 2013 Aug 9. [Epub ahead of print]
4.    Czecior E, Scierski W, Misiołek M, et al. Reconstruction of the larynx after a resection of a huge chondrosarcoma. Otolaryngol Pol 2011;65:459-61.