Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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November 10, 2014
Thyroid Cartilage Chondrosarcoma
- An uncommon malignant neoplasm of cartilage, laryngeal chondrosarcoma represents less than 0.2% of head and neck malignancies, and 1% of laryngeal tumors. Head and neck cartilage distribution: 72% cricoid, 20% thyroid, and rarely, arytenoid.
- Slow-growing, low-grade neoplasm (unless poorly differentiated subtype).
- Clinical Presentation: Mean age: 4th to 6th decade, 5–10 times male predominance. Presents with slowly worsening hoarseness and dyspnea. Occasionally seen with dysphagia and a palpable neck mass. Referred otalgia can be seen.
- Key Diagnostic Features:
- CT is the preferred imaging modality, demonstrating a calcified mass involving laryngeal or tracheal cartilage.
- Tumor matrix can demonstrate fine, punctate, stippled-to-coarse calcifications (popcorn and/or ring appearance).
- Moderate postcontrast enhancement of the soft-tissue component.
- MRI may improve delineation of soft-tissue involvement.
- Pathologic grade I–III (higher grade correlates to poor differentiation and worse prognosis).
- DDx:
- Chondroma
- Other sarcoma types
- Rx: Surgery. Chemotherapy and radiotherapy have a limited role to play.
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