A pathologist reviews a laryngectomy specimen and describes a squamous cell carcinoma that involves both the ventricular band region and the true vocal cord, having crossed the laryngeal ventricle with extension into the paraglottic space. How should this tumour be classified?
- A Transglottic carcinoma, arising from and spanning across the laryngeal ventricle ✓
- B Supraglottic carcinoma with secondary glottic invasion via pre-epiglottic space
- C Glottic carcinoma confined to the vocal ligament
- D Hypopharyngeal carcinoma with direct laryngeal extension
Correct answer: A. Transglottic carcinoma, arising from and spanning across the laryngeal ventricle
Explanation
A transglottic tumour crosses the laryngeal ventricle to involve both the supraglottis and glottis, spreading readily through the paraglottic space because the ventricle lacks a firm barrier there. This route explains late presentation with fixed cords and poorer prognosis. Pre-epiglottic spread defines supraglottic extension anteriorly, not the defining feature here, and a purely glottic tumour remains below the ventricle. Hypopharyngeal primaries invade the larynx through the pyriform sinus, not across the ventricle.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
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