The patterns of growth and spread of laryngeal cancer

Clinical and conventional radiological examination are often insufficient for an exact delineation of the extent of the tumor, particularly in intramural forms without involvement of the mucosa [1]. Histologic examination of large series of surgical specimens after laryngectomy has yielded valuable information on the modes of invasion of laryngeal carcinoma [2–6]. The growth and spread of laryngeal carcinoma are determined by the site of origin of the primary tumor. Local and regional spread is often mechanical in nature. Major factors in determining the direction and extent of the tumor growth are anatomical barriers produced by the laryngeal compartments, the anterior commissure, the cartilagenous framework and intercartilagenous membranes. Within these barriers there are strong and weak points, which may modify the diffusion of cancer.