Ventriculosaccular carcinoma of the larynx.

The question of whether or not carcinoma arises in the ventricles and saccules of the larynx is a controversial one. These areas of the larynx have pseudostratified columnar ciliated epithelium. In the past several authors have not believed that carcinomas arise in these areas because of the absence of squamous metaplasia in their observations. However, other workers have been convinced that such tumours do arise and that they behave in certain specific ways. In order to clear up the controversy, these areas were studied in 154 laryngeal specimens examined by a serial sectioning technique. In this study 14.3% of the laryngeal specimens studied showed clear evidence of tumour emanating from these areas. Areas of squamous metaplasia with carcinoma in situ and frank invasion have been observed in many of these cases. These tumours spread by concentric enlargement within the paraglottic space and are often diagnosed late since they are difficult to observe from above. Patients who present with hoarseness and a mucosa-covered swelling in the false cord area should be carefully examined if a carcinoma arising in this area is not to be missed.