Orvidas L J, Olsen K D, Lewis J E, Suman V J
Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Head Neck. 1998 May;20(3):197-203. doi: 10.1002/(sici)1097-0347(199805)20:3<197::aid-hed3>3.0.co;2-w.
Verrucous carcinoma of the larynx is a rare laryngeal neoplasm that can be confused with a benign process. Although usually curable at an early stage, it can be locally aggressive if left untreated. We describe our experience with this tumor and make recommendations for diagnosis and treatment.
From 1960 through 1990, 53 patients received initial treatment for verrucous carcinoma of the larynx at the Mayo Clinic. We retrospectively reviewed the presentation, diagnosis, treatment, and outcomes in these patients. All cases were confirmed by histologic examination.
All but two patients were men, and most were smokers. Most tumors were found in the glottis, and 72% were T1 lesions at presentation. Six patients had hybrid tumors consisting of conventional squamous cell carcinoma along with the verrucous component. Sixteen patients had lesions that had been diagnosed as benign before they were seen at our institution. Treatment ranged from transoral excision to laryngopharyngectomy. Ten patients experienced recurrence, but only two patients died of the tumor. No pure verrucous lesion metastasized, and overall survival was similar to that of an age- and sex-matched cohort from the Western North Central U.S. white population.
When discovered early, verrucous carcinoma of the larynx can be treated by local excision with good results; extensive lesions, however, may require more-aggressive procedures. Close communication between the pathologist and the clinician as well as adequate biopsy is essential for diagnosis. Patients with a conventional squamous cell carcinoma coexistent with a verrucous lesion must be treated as if they had invasive squamous cell carcinoma.
喉疣状癌是一种罕见的喉部肿瘤，可能会与良性病变相混淆。尽管通常在早期可治愈，但如果不治疗，它可能具有局部侵袭性。我们描述了我们对这种肿瘤的治疗经验，并提出诊断和治疗建议。
1960年至1990年期间，53例患者在梅奥诊所接受了喉疣状癌的初始治疗。我们回顾性地分析了这些患者的临床表现、诊断、治疗及预后情况。所有病例均经组织学检查确诊。
除两名患者外，其余均为男性，且大多数患者吸烟。大多数肿瘤位于声门，72%的患者初诊时为T1期病变。6例患者的肿瘤为混合型，包含传统鳞状细胞癌成分及疣状成分。16例患者在我院就诊前被诊断为良性病变。治疗方式包括经口切除至喉咽切除术。10例患者出现复发，但仅2例患者死于该肿瘤。无纯疣状病变发生转移，总体生存率与美国中西部北部白种人群年龄及性别匹配的队列相似。
喉疣状癌早期发现时，通过局部切除治疗效果良好；然而，广泛病变可能需要更积极的手术。病理学家与临床医生之间的密切沟通以及充分的活检对于诊断至关重要。伴有传统鳞状细胞癌的疣状病变患者必须按照侵袭性鳞状细胞癌进行治疗。
