Chondrosarcoma of Larynx



Chondrosarcoma of Larynx


Lawrence E. Ginsberg, MD









(Left) Axial CECT in a 55-year-old woman with hoarseness shows a predominantly hypodense chondrosarcoma image arising from the left cricoid cartilage with internal calcifications image. (Right) Axial bone CT in the same patient shows more clearly the multiple internal calcifications image within the chondrosarcoma. Laryngeal chondrosarcoma arises from the cricoid cartilage approximately 70% of the time.






(Left) Axial T2 fat-saturated MR in the same patient shows CSa as a hyperintense mass image impinging on the subglottic lumen image. Lack of heterogeneity is surprising given the CT evidence of intramural calcifications. (Right) Axial bone CT in a different patient shows a noncalcified low-grade CSa image. In such a case, imaging cannot differentiate chondrosarcoma and benign chondroma. Note the tracheostomy apparatus image, necessitated by airway compromise image caused by the tumor.



TERMINOLOGY


Abbreviations



  • Chondrosarcoma (CSa)


Definitions



  • CSa, larynx: Cartilage-producing chondrocytic neoplasm with cellular atypia, bone destruction, or local invasion


IMAGING


General Features



  • Best diagnostic clue



    • Expansile mass arising within laryngeal cartilage with intact mucosal surfaces, arc or ring-like calcification


  • Location



    • In larynx, most arise in cricoid (posterior or posterolateral) > thyroid cartilage (inferolateral)



      • Cricoid cartilage: 72%, thyroid cartilage: 20%


    • Rare in arytenoid cartilage or epiglottis


    • Typically subglottic in location


  • Size



    • 1-6 cm


    • Often large at presentation if airway is spared



      • Tumor growing away from laryngeal lumen


  • Morphology



    • Bulky, lobular mass


    • Chondroid matrix typical


Radiographic Findings



  • Radiography



    • Mass of variable density may be exophytic from laryngeal cartilage or grow inward thereby narrowing the laryngeal air column


    • Stippled calcifications


CT Findings



  • NECT



    • Ring-like or “popcorn” calcifications in expansile mass arising from cricoid or thyroid cartilage with smooth mucosal covering


    • Not all tumors are calcified

Sep 20, 2016 | Posted by in HEAD & NECK IMAGING | Comments Off on Chondrosarcoma of Larynx
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