Early stage carcinomas of the larynx usually manifest in persisting and slowly increasing voice hoarseness. The carcinoma gradually impairs laryngeal functions and can also cause inflammatory reactions in the surrounding tissue at a later stage. In the majority of cases, the carcinomas remain localized. However, they can also form metastases in regional as well as distant lymph nodes in up to 40% of patients [1]. Metastases most likely develop in the liver and the lungs. Both the site and the stage of the carcinoma determine the spectrum of possible symptoms. Dysphonia which will gradually develop into aphonia, dysphagia, dyspnea, aspiration, fatigue and general weakness, localized pain, otalgia, halitosis and blood showing in the patient's sputum as well as general cachexia, tissue expectoration and suspicious local tissue development in the neck in advanced carcinoma stages can be noted in the clinical presentation [2].

Carcinomas of the larynx are strongly connected to certain lifestyle risk factors like smoking and alcohol abuse as well as advanced age (above 60 years) [3]. It is more common in males. The probability to develop a carcinoma of the larynx is sixteen times higher in smokers than in non-smokers [4] with a significant detrimental memory effect in former smokers [5]. Restarting the smoking habit during or after carcinoma treatment diminishes healing chances and also increases the risk for the development of further carcinomas [6]. Notably, the probability of developing early-stage disease has declined in the past decades [7]. In the case of patients with a drug history, it is most likely that the patients have accumulated further drug-related ailments that turn out to be fatal than carcinomas of the larynx.

• Weight Loss

  Weight loss. Unintentional weight loss may signal an underlying cancer. [everydayhealth.com]

  Symptoms of these cancers may include: A sore throat that does not go away Constant coughing Pain when swallowing Trouble swallowing Ear pain Trouble breathing Weight loss A lump or mass in the neck (due to spread of the cancer to nearby lymph nodes) [cancer.org]

  loss Fatigue If you are concerned about any changes you experience, please talk with a doctor and/or dentist, especially if they don’t go away or get worse. [cancer.net]

  loss, or fatigue (extreme tiredness). [nhs.uk]

  Signs of Laryngeal Cancer Cancer may cause: Hoarseness or voice changes Problems swallowing Feeling like you have a lump in your throat A bad cough or chest infection Feeling short of breath Bad breath Weight loss An earache that lasts for a long time [asha.org]

• Malnutrition

  Complications Dysphagia, malnutrition. Loss of voice. Tracheo-innominate artery fistula and pharyngocarotid artery fistula. Loss of taste - potentially aggravating inadequate nutrition. [patient.info]

  Tumor growth by local extension in the larynx can cause a patient's airway to be compromised or the swallowing function to be interrupted (which leads to problems eating and subsequent malnutrition), as well as causing the loss of the protection of the [oncolink.org]

• Euthyroid

  […] patients who underwent curative radiotherapy for T1/T2 laryngeal cancer between 1998 and 2002. 33 patients were identified (mean 66.85 years, range 48-93). 19 patients had T1 lesions (58%), 14 had T2 lesions (42%) and 27 were N0 (82%). 23 patients were euthyroid [ncbi.nlm.nih.gov]

• Cervical Lymphadenopathy

  Subglottic cancer presents with dyspnea, stridor, or palpable cervical lymphadenopathy. [health.am]

• Hoarseness

  It affected a 78-year-old male who presented initially with hoarseness and bloody sputum. The patient had suffered from continuing hoarseness and bloody sputum for three months before he consulted an otorhinolaryngologist one month ago. [ncbi.nlm.nih.gov]

  Hoarseness or voice changes Laryngeal cancers that form on the vocal cords (glottis) often cause hoarseness or a change in the voice. This can lead to them being found at a very early stage. [cancer.org]

  Early diagnosis is common with vocal cord tumors because hoarseness develops early. [merckmanuals.com]

• Cough

  KEYWORDS: Adenoid cystic carcinoma; Fiberscopy; Larynx; Prolonged cough; Subglottic mass [ncbi.nlm.nih.gov]

  Feeling like you need to cough. Constant irritation of the throat and feeling like you have to cough or clear your throat can be an early cancer symptom. Breathing problems. [everydayhealth.com]

  Symptoms of these cancers may include: A sore throat that does not go away Constant coughing Pain when swallowing Trouble swallowing Ear pain Trouble breathing Weight loss A lump or mass in the neck (due to spread of the cancer to nearby lymph nodes) [cancer.org]

  Chondrosarcoma (cancer of the cartilage) Adenocarcinoma Adenoid cystic carcinoma (form of salivary gland cancer) Metastases from other cancers Laryngeal Cancer Symptoms Laryngeal cancer symptoms include: Persistent hoarseness or change in voice A sore throat or cough [cancer.osu.edu]

  Some of the most common signs include: hoarse voice breathing difficulties excessive coughing cough with blood neck pain sore throat ear pain trouble swallowing food neck swelling neck lumps sudden weight loss These symptoms don’t always occur with cancer [healthline.com]

• Dyspnea

  Dyspnea was the most common complaint. All patients underwent combined-modality treatment with surgical resection and external beam radiation. The range of follow-up time varied from 1 to 7 years (median 5 years). [ncbi.nlm.nih.gov]

  Dysphonia which will gradually develop into aphonia, dysphagia, dyspnea, aspiration, fatigue and general weakness, localized pain, otalgia, halitosis and blood showing in the patient's sputum as well as general cachexia, tissue expectoration and suspicious [symptoma.com]

  Subglottic cancer presents with dyspnea, stridor, or palpable cervical lymphadenopathy. [health.am]

  Because most spindle cell tumors are polypoid and pedunculated, and tend to cause obstructive symptoms such as hoarseness, dyspnea, and dysphagia, most tumors without metastasis are detected early and tend to have a very good 5-year prognosis. [ccij-online.org]

  Ask about dysphagia, persistent cough, hemoptysis, weight loss, dyspnea, or pain that radiates to the ear, which are late symptoms of laryngeal cancer. [medical-dictionary.thefreedictionary.com]

• Stridor

  Late symptoms include dysphagia, odynophagia, stridor, or cough. Subglottic cancer presents with dyspnea, stridor, or palpable cervical lymphadenopathy. [health.am]

  Case Report A 70-year-old male presented to our department with a 1-year history of progressive hoarseness and stridor since last 1 week. [ccij-online.org]

  A noisy type of breathing called stridor may occur if the opening between the vocal cords is narrowed by a laryngeal cancer. Difficulty swallowing. [everydayhealth.com]

  Symptoms may include the following: [3] [4] Hoarseness or other voice changes A lump in the neck A sore throat or feeling that something is stuck in the throat Persistent cough Stridor - a high-pitched wheezing sound indicative of a narrowed or obstructed [en.wikipedia.org]

  […] and Signs of Larynx Cancer A person should seek early medical attention if he has a persistent hoarse voice or a persistent sore throat, a painless lump in the neck, feels pain on swallowing, has difficulty swallowing, or has noisy breathing known as stridor [nccs.com.sg]

• Hemoptysis

  Supraglottic cancers tend to present late with symptoms of dysphagia, odynophagia, hemoptysis, or referred otalgia. Stridor and hoarseness are late findings. Palpable cervical lymphadenopathy is a common presenting sign. [health.am]

  Ask about dysphagia, persistent cough, hemoptysis, weight loss, dyspnea, or pain that radiates to the ear, which are late symptoms of laryngeal cancer. [medical-dictionary.thefreedictionary.com]

  Majority occur in anterior 2/3 of vocal cords Symptoms - persistent hoarseness, later dyspnea, chronic cough, hemoptysis, stridor Staging T1 - limited to vocal cords, with normal mobility T1a - limited to one vocal cord T1b - involves both vocal cords [en.wikibooks.org]

• Odynophagia

  Late symptoms include dysphagia, odynophagia, stridor, or cough. Subglottic cancer presents with dyspnea, stridor, or palpable cervical lymphadenopathy. [health.am]

  There were no associated complaints of dysphagia, odynophagia, or weight loss. There was no history of tuberculosis, trauma, or any focal neurological deficit. He was a chronic smoker since last 40 years. [ccij-online.org]

• Halitosis

  Dysphonia which will gradually develop into aphonia, dysphagia, dyspnea, aspiration, fatigue and general weakness, localized pain, otalgia, halitosis and blood showing in the patient's sputum as well as general cachexia, tissue expectoration and suspicious [symptoma.com]

  Diagnosis Signs and Symptoms Persistent hoarseness in an elderly or middle-aged cigarette smoker Dyspnea and stridor Ipsilateral otalgia Dysphagia Odynophagia Chronic cough Hemoptysis Weight loss owing to poor nutrition Halitosis owing to tumor necrosis [health.am]

  Dyspnoea and stridor, pain, dysphagia, cough, swelling in the neck, haemoptysis, halitosis, reflective otalgia, tenderness of the larynx and weight loss can also occur during the course of disease. [atlasgeneticsoncology.org]

• Otalgia

  A 74 year old man who presented with otalgia underwent direct laryngoscopy with biopsy, which revealed an invasive poorly differentiated carcinoma. [ncbi.nlm.nih.gov]

  Dysphonia which will gradually develop into aphonia, dysphagia, dyspnea, aspiration, fatigue and general weakness, localized pain, otalgia, halitosis and blood showing in the patient's sputum as well as general cachexia, tissue expectoration and suspicious [symptoma.com]

  Supraglottic cancers tend to present late with symptoms of dysphagia, odynophagia, hemoptysis, or referred otalgia. Stridor and hoarseness are late findings. Palpable cervical lymphadenopathy is a common presenting sign. [health.am]

  Patients with supraglottic cancer often present with dysphagia; other common symptoms include airway obstruction, otalgia, development of a neck mass, or a "hot potato" voice. [merckmanuals.com]

  (Outside the field of otorhinolaryngology, many physicians do not realize that otalgia may be a sign of laryngeal cancer. [emedicine.medscape.com]

• Referred Otalgia

  Supraglottic cancers tend to present late with symptoms of dysphagia, odynophagia, hemoptysis, or referred otalgia. Stridor and hoarseness are late findings. Palpable cervical lymphadenopathy is a common presenting sign. [health.am]

• Neck Mass

  A 56-year-old, diabetic male presented with a 2.5-cm, left-sided neck mass. Fine needle aspiration showed a mixture of malignant squamous and spindle cells. A third population of osteoclastlike giant cells was also present. [ncbi.nlm.nih.gov]

  Patients with supraglottic cancer often present with dysphagia; other common symptoms include airway obstruction, otalgia, development of a neck mass, or a "hot potato" voice. [merckmanuals.com]

  Fine-needle aspiration (FNA) of a neck mass. [patient.info]

• Neck Swelling

  Some of the most common signs include: hoarse voice breathing difficulties excessive coughing cough with blood neck pain sore throat ear pain trouble swallowing food neck swelling neck lumps sudden weight loss These symptoms don’t always occur with cancer [healthline.com]

Diagnosis must start with a thorough check of the patient's background and lifestyle. The development of a carcinoma of the larynx can also be related to an infection with human papillomavirus (HPV) [8]. A physical exam involving direct laryngoscopy is inevitable. It is highly advisable to perform a biopsy of a potential early-stage tumor. Depending on the location and the development stage of the carcinoma, further tests to be considered are computed tomography (CT) scans of the chest, head and neck, magnetic resonance imaging (MRI) as well as positron emission tomography (PET). The aim of these tests is to determine the degree of tumor invasion into surrounding tissues which will also define the odds of patient survival.

Late-stage tumors with a significant depth of invasion and metastatic spread are fatal [9]. Localized tumors have healing chances between 75% and 95% [10].

• Helicobacter Pylori

  BACKGROUND: Infection with Helicobacter pylori (H. pylori) plays a role in the development of gastric carcinoma. However, there is controversy as to whether H. pylori infection increases laryngeal or pharyngeal cancers. [ncbi.nlm.nih.gov]

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