Laryngeal carcinoma: the role of computed tomography in the pre therapeutic assessment.

Congress:

ECR 2020

Poster Number:

C-06095

Type:

Educational Exhibit

Keywords:

Not applicable, Neoplasia, Metastases, Cancer, Computer Applications-3D, MR, CT, Oncology, Head and neck, Computer applications, Head and Neck

Authors:

E. Brichni¹, S. Essghaier¹, M. A. Guizani¹, A. Zidi²; ¹Tunis/TN, ²El Kram/TN

DOI:

10.26044/ecr2020/C-06095

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-06095

Fig. 1: Axial images parallel to vocal cords and the C5-C6 disk.

Fig. 2: axial and coronal enhanced Ct with phonation maneuver showing a glottic and...

Fig. 3: Coronal and axial enhanced Ct showing a large mass of the left ventricular cord...

Fig. 4: Axial (A) and coronal (B) enhanced cervical computed tomography showing a mass...

Learning objectives

Recall the protocol of cervical computed tomography in the pre-therapeutic staging of laryngeal cancer Illustrate through a rich iconography the main aspects of loco-regional extension of laryngeal cancer. Highlight the interest of computed tomography in the pre-therapeutic staging of laryngeal cancer

Background

I.Introduction : Laryngeal cancer represents 28% of the upper aero-digestive carcinomas. Its main factors are tobacco consumption and alcohol abuse. The main symptom is dysphonia, associated with dyspnea or dysphagia, according totumor's topography. Clinical examination, including the endoscopyn,allows depicting superficial spread of the carcinoma. Nether less, extension to deeper spaces of the larynx, to extra laryngeal tissues and to cartilage is underestimated by clinical examination. Thus, imaging plays a complementary role. It also provides informations about cervical and mediastinal lymph nodes, distant metastases and synchronous...

Findings and procedure details

I.Computed tomography Supra-glottis Supraglottis is delimited superiorly by the hyoid bone and inferiorly by the upper surface of the vocal cords. 1.Epiglottis Tumors of suprahyoid epiglottiscan spread to valleculs, glosso-epiglottic fold and base of the tongue. Tumors of infrahyoid epiglottis can spread to pre-epiglottic space threw vascular perforationsand then infiltrates the para-glottic space and the glottis. On CT it is analysed on axial images and sagittal reconstructions. Its encroachment is seen as enhanced thickening of its surfaces. 2.Ventricular cords: From the ventricular cords, the tumor...

Conclusion

Computed tomography plays a key role in the pre-therapeutic staging of laryngeal cancer. It permits depicting extension to deep spaces, laryngeal cartilage and extra-laryngeal tissues. It provides important informations allowing the physician to choose the best suitable therapy.

Personal information and conflict of interest

E. Brichni; Tunis/TN - nothing to disclose A. Zidi; El Kram/TN - nothing to disclose S. Essghaier; Tunis/TN - nothing to disclose M. A. Guizani; Tunis/TN - nothing to disclose

References

Dubrulle F, Souillard R, Chevalier D, Puech P. Imagerie en cancérologie du larynx et de l’hypopharynx. J Radiol. 2008;89(7):998‑1012. Becker M, Zbären P, Casselman JW, Kohler R, Dulguerov P, Becker CD. Neoplastic invasion of laryngeal cartilage: reassessment of criteria for diagnosis at MR imaging. Radiology. 2008;249(2):551‑9. Céruse P, Ltaief Boudrigua A, Buiret G, Cosmidis A, Tringali S. Anatomie descriptive, endoscopique et radiologique du larynx. Encycl Med Chir. (Elsevier Masson, Paris), Oto-Rhino-Laryngologie, 20-630-A-10, 2012, 28p Agnello F, Cupido F, Sparacia G, Midiri F, Miroddi M, Grassedonio...