characterised by the presence of both well-differentiated CS and a high-grade non-cartilaginous sarcoma is even rarer [46, 128, 259, 360].

Immunohistochemically, CS expresses S-100 protein and vimentin [46].

Differential diagnosis includes chondroma and chon-drometaplasia. Differentiation between low-grade CS and chondroma can be extremely difficult, and is only possible with adequate tumour sampling. Chondromas are considered to be exceedingly rare in the larynx; they are smaller than CS and less cellular, with less pleomor-phism, lacking mitoses and necrosis.

The treatment of choice is conservative surgery [46, 182, 209]. Total laryngectomy should be avoided as long as possible, even in recurrent CS. Radiation therapy is generally regarded as ineffective though a few cases with a favourable response to radiation have been reported [141].

The prognosis is favourable. CS is characterised by a slowly progressive growth, with frequent recurrences (18-40%) that are related to incomplete surgical excision and/or higher tumour grade [360]. Metastases from laryngeal CS are unusual and are reported in approximately 10% of patients, most commonly to the lungs and lymph nodes [259, 360]. The 5- and 10-year survival rates are 90 and 80.9% respectively.

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