Submucosal cancer extension through mucous glands occurs in the larynx. In a study of 45 cases, many lesions were too advanced to accurately state what had been the mode of spread. The majority of lesser lesions had clearly invaded according to the pattern predicted by the glandular theory. This theory offers an explanation for many clinical observations hitherto not completely understood—for example, the time honored dictum that supraglottic tumors tend not to invade the glottis but to penetrate the preepiglottic space. Anterior commissure tumors are difficult to treat because of their dissemination throughout the anterior subglottic mucous glands. Many new predictions are made; for example, on the behavior of ventricular and saccular tumors and on the distinction between cancers arising on the superior surface of the vocal cord and those showing mainly subglottic extension.
G. Patrick Bridger, Victor H. Nassar. Cancer Spread in the Larynx. Arch Otolaryngol. 1972;95(6):497–505. doi:10.1001/archotol.1972.00770080787002