Laryngeal malignant neoplasms in children and adolescents

An exhaustive literature review of the last two decades discloses 47 laryng eal malignant neoplasms in children and adolescents. The most frequent mali gnant neoplasm is the embryonal variant of rhabdomyosarcoma. The timely dia gnosis of a laryngeal neoplasm depends on maintaining a high index of suspi cion in a patient with progressive airway obstruction, dysphagia or dysphon ia, and conducting an efficient work-up-including magnetic resonance imagin g and direct laryngoscopy under general anesthesia in association with bron choscopy-in order to define the extent of the lesion, rule out multiple les ions, establish and maintain an airway, and perform a biopsy of the tumor. The authors observed that several risk factors, such as previous radiation therapy for juvenile laryngeal papillomatosis, intrauterine exposure to ion izing radiation, chemical carcinogens, smoking or tobacco exposure were lac king in those patients with a detailed clinical history. Probably, cancer o f the larynx in these unusual patients is the final result of an interactio n of immunological and genetic factors. The choice of therapy depends on se veral factors, including the clinical stage at presentation, histological t ype and potential radio-chemosensitivity of the tumor. (C) 1999 Elsevier Sc ience Ireland Ltd. All rights reserved.