Ventriculosaccular carcinoma of the larynx

A series of 76 cases of laryngeal carcinoma was examined in transverse slices using a motorized slicing machine. Eleven cases of ventriculosaccular carcinoma were detected by this method and the topography and gross appearances of the tumours in the larynges are described. Microscopy of the tumour indicates a keratinizing squamous cell carcinoma the mode of growth of which seems to be by concentric expansion through the whole margin rather than by invading tongues of tumour. In no case was there invasion of laryngeal cartilages or extension to the surgical cut surface of the specimen. The clinical, radiological and biopsy features in 10 of the 11 patients are described. In follow-up studies, which were 12 years or longer in five patients, none had lymph node metastases or recurrences of the laryngeal carcinoma of any sort. The following features may suggest the diagnosis of ventriculosaccular carcinoma before laryngectomy: (1) a ventricular tumour, (2) a supraglottic bulge above it, (3) a paraglottic swelling on CT scan radiology covered by a smooth laryngeal lining and (4) biopsy appearances of a well differentiated 'folded carcinoma'.