Laryngeal squamous cell carcinoma variants: clinical and pathological
analysis of 110 patients over a 10-year period
Abstract
Objectives: Squamous cell carcinoma(SCC) is the most common laryngeal
neoplasm. Squamous cell carcinoma variants (vSCC), on the other hand,
show different clinical and pathological features than conventional
type. The purpose of this study is to analyze the clinical and
pathological findings of vSCC of the larynx. Methods: This retrospective
study evaluates 110 patients diagnosed with vSCC in our institution
between 2006-2017. Treatment of primary and recurrent diseases was
evaluated. Overall survival, disease-specific survival and follow-up
times were calculated as months. Difference between preoperative and
postoperative pathology reports of surgically treated patients were
compared. Results: There were 1497 patients diagnosed with laryngeal
malignancy and 110 (7,34%) of these patients were diagnosed with vSCC.
The most common pathological subgroup was verrucous carcinoma. The best
prognosis was found in verrucous carcinoma and the worst was in spindle
cell carcinoma. Overall survival rates was 90% and 54.7%,
respectively. A group of patients had a preoperative pathological
diagnosis, not vSCC, but conventional SCC with the incidence of
38.5-100% according to the histological subtype. This was most common
in acantholytic carcinoma, followed by adenosquamous, basaloid and
spindle cell carcinoma, respectively. Conclusions: Spindle cell
carcinoma and basaloid type squamous cell carcinoma have the worst
prognosis and the highest metastatic potential. Patients diagnosed with
these two variants should be followed up more cautiously. It should also
be kept in mind that the diagnosis of vSCC can be missed in patients
diagnosed only with a small tissue biopsy sample.