Clinical features

Patients with LCS typically present with hoarseness, and/or airway obstruction and dyspnoea. An external neck mass may be noted when it arises in the thyroid lamina. These tumours grow slowly and can be asymptomatic until they reach considerable size. On examination, the usual appearance is that of a subglottic swelling with intact mucosa. Vocal cord paralysis is a common finding at presentation. LCS have characteristic features on CT examination, with expansion of the affected cartilage by a relatively circumscribed, hypodense mass containing stippled to coarse calcifications. MR

imaging may show better definition of the tumour boundaries but is less likely to detect internal calcifications {255,1888, 2598}. LCS are notoriously difficult to biopsy. Their characteristic imaging appearance precludes the necessity for preoperative biopsy.

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