CARTILAGINOUS TUMORS OF THE LARYNX

Cartilaginous tumors of the larynx, while rare, will on occasion be en countered by the otolaryngologist in routine daily practice. True lary ngeal chondromas are exceedingly rare, and as a consequence, a putativ e diagnosis of chondroma should be viewed with suspicion. On pathologi c examination, laryngeal chondromas usually prove to be small lesions (less than 2 cm in maximum dimension) and may arise in children or adu lts. Laryngeal chondrosarcomas, by contrast, usually prove to be large r lesions(exceeding 3 cm in greatest dimension) and are typically foun d in adults. While high-grade chondrosarcomas are readily identifiable on light microscopic study, the distinction between a chondroma and a low-grade chondrosarcoma is often not so clear-cut. Some low-grade ch ondrosarcomas may show a slight increase in both cellularity and cytol ogic atypia when compared with chondromas, but the two patterns often overlap. When faced with a limited biopsy specimen of a laryngeal cart ilaginous lesion in which neither increased cellularity nor recognizab le cytologic atypia is found, a diagnosis of ''cartilaginous tumor wit hout obvious evidence of malignancy-further classification dependent o n examination of the lesion in its entirety,'' or words to this effect is recommended.