Metastases to the Larynx

Metastases to the larynx from distant primary tumours are uncommon, accounting for less than 0.5% of all laryngeal neoplasms. Metastases to the hypo-pharynx and trachea are even less common. The most common source is malignant melanoma (Fig. 7.15), followed by renal cell carcinoma. Other tumours with proven laryngeal metastases include cancer of the breast, lung, prostate, colon, stomach and ovary [24, 74, 105, 154, 267, 296]. The rare occurrence of metastases to the larynx seems to be related to the terminal location of this organ in the lymphatic and vascular circulation.

Laryngeal metastases are most commonly located in the supraglottic and subglottic regions, presumably due to their rich vascular supply [24, 133]. They can be divided into those located in the soft tissue (metastases from melanoma and renal cell carcinoma) and those located primarily in the marrow spaces of the ossified laryngeal cartilage (metastases from breast, prostate, and lung cancer).

The signs and symptoms of metastatic laryngeal tumours do not differ from those of other laryngeal tumours and vary according to the site of involvement. Haemoptysis may be present, especially in highly vascu-larised metastatic renal cell carcinoma.

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