A 60-year-old man with hoarseness undergoes contrast-enhanced CT of the neck. A mass involving the true vocal cord is identified with erosion of the inner cortex of the thyroid cartilage. The most appropriate next step in management is:

• A Total laryngectomy ✓
• B Laser cordectomy
• C Radiation therapy alone
• D Neoadjuvant chemotherapy

Explanation

CT evidence of thyroid cartilage invasion (especially through the inner cortex) upstages laryngeal carcinoma to T4a and makes organ-preservation approaches like radiation or conservative surgery inadequate. Total laryngectomy is the standard of care for T4a disease. Cordectomy is limited to T1-2 lesions confined to the cord without cartilage involvement.

Reference: Cummings Otolaryngology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.