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Clinical Problem Solving: Radiology
July 2004

Radiology Quiz Case 2—Diagnosis

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Copyright 2004 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2004

Arch Otolaryngol Head Neck Surg. 2004;130(7):895-896. doi:10.1001/archotol.130.7.895

Chondrosarcoma is the most common mesenchymal malignant tumor of the larynx, with approximately 250 cases reported in the world medical literature. It is less aggressive in the larynx than elsewhere; cervical or distant metastases are rare (8.5%), and although local recurrences are not uncommon, they are not catastrophic.1

Laryngeal chondrosarcoma most often occurs in patients between the ages of 50 and 70 years, with a male-female ratio of 3:1.2 The most common site of origin is the cricoid cartilage (75%), especially the posterior lamina. However, there are also reports of onset in the thyroid, epiglottis, arytenoid, and accessory cartilages. The most common presenting symptoms of laryngeal chondrosarcoma are progressive hoarseness, dyspnea, and dysphagia, which vary according to tumor location. Because the neoplasm is usually slow growing, the patient may adapt to progressive narrowing of the airway until an episode of acute inspiratory dyspnea leads to an emergency tracheotomy. When the neoplasm originates in the cricoid or thyroid cartilage, the major complaint may be the presence of a hard mass in the neck.1

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