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Premalignant changes in the vocal cord
Author(s) -
Robbett William F.
Publication year - 1972
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-197206000-00008
Subject(s) - carcinoma in situ , larynx , medicine , actinic keratosis , keratosis , pathology , cord , carcinoma , dermatology , anatomy , surgery , basal cell
The subject of premalignant changes in the vocal cords encompasses a very extensive scope; therefore, only two aspects are discussed in this presentation. The two most common clinically identifiable entities that progress to invasive carcinoma are examined, namely, keratosis and carcinoma in situ . The treatment of keratosis and carcinoma in situ is probably the most provocative subject in laryngeal disease. There is a great difference of opinion as to the action or inaction to be taken when these conditions are identified in the larynx. Keratosis may appear in two forms: delineated keratosis and diffuse keratosis. They_have distinct‐Glinical appearances and have a different potential for malignant progression. The treatment of carcinoma in situ is a very controversial subject. The value and advisability of treating this disease with irradiation is questioned. The use of microlaryngeal surgery has been a valuable aid in the identification and delineation of both of these diseases of the vocal cords. The second part of this presentation discusses the role of the submucosa in intraepithelial and early invasive carcinoma of the vocal cord. Some interesting investigative studies have been performed in the study of the role of the stroma in epidermal carcinogenesis. These observations suggest the possibility of stromal elements being of pathogenic importance in the origin of epithelial tumors. The very rapid reappearance of carcinoma_ in situ in the regenerated epithelium of the vpcal cord after complete mucosal removal is suggestive of some extra‐epithelial stimulus. Both vocal cords being exposed to the same extrinsic irritants, carcinoma in situ will frequently appear only in the regenerated epithelium of the vocal cord that first evidenced the disease. Multicentric foci of carcinoma is mentioned but not discussed in the presentation.