Symptoms
The leading symptom of vocal fold carcinoma is hoarseness. This can of course also have a variety of other causes, but if hoarseness persists for more than three weeks (most hoarseness caused by inflammation usually disappears within two weeks), you should definitely see an ear, nose and throat doctor. Other symptoms are irritable cough or, in advanced stages, difficulty breathing or swallowing.
Carcinoma of the vocal folds only rarely develops metastases (daughter tumors) and if so, then late, because this area is only very sparsely supplied with lymph vessels that can carry away tumor cells. If metastases do occur, they usually occur regionally (i.e. in the immediate vicinity of the vocal folds) or in the liver or lungs. More frequently, namely in about 20-30% of those affected, so-called secondary carcinomas occur, which are usually located in the upper respiratory tract or lungs. Both secondary tumors and metastases can cause additional symptoms depending on their location.
Diagnostics
If vocal fold carcinoma is suspected, the ear, nose and throat physician performs a direct or indirect laryngoscopy to assess the larynx and vocal folds. In the presence of a carcinoma, the vocal fold is typically reddened and thickened, sometimes a defect in the mucous membrane (ulceration) or a whitish fibrin coating is also visible. In a later stage of the disease, the carcinoma may grow into the stellate cartilage (ary cartilage).
In such patients the mobility of the vocal folds is restricted and they are no longer in their typical position. In order to get a more precise statement about this, the ability of the vocal folds to vibrate can be checked by means of a stroboscopy. In order to secure the diagnosis, a small piece of suspicious tissue is removed from the larynx under local anesthesia (by means of sample excision = PE or fine needle puncture), which is then sent for microscopic examination (histology).In order to better assess how far and how deep a carcinoma has already grown, computer tomography (CT) or magnetic resonance imaging (MRI) can be performed. In order to search for any metastases that may be present, an ultrasound examination (sonography) is also recommended, which is also suitable for monitoring the progress of the cancer.
