Chondrosarcoma of the Subglottic Larynx: Submucosal Microdissection With the Operating Microscope

Objectives/Hypothesis: Chondrosarcoma is a rare malignancy of the head and neck with fewer than 600 cases described in the literature. Treatment typically consists of conservation surgery with preservation of airway and preoperative voice quality. We describe five patients treated with a conservative transcervical approach utilizing the operating microscope for submucosal microdissection. Study Design: Retrospective case series at a National Cancer Institute-designated comprehensive cancer center. Methods: A retrospective case series from February 2004 to February 2011 was performed for all consecutive patients with laryngeal chondrosarcoma treated by the senior author with transcervical submucosal microdissection utilizing the operating microscope. Results: Five patients with laryngeal chondrosarcoma were treated between February 2004 and February 2011. There were three male and two female patients who ranged in age from 56 to 87 years (mean, 72 years) at presentation. All five tumors were located at the level of the cricoid cartilage. Hoarseness was the most common presenting symptom (60%). Eighty percent of patients had limited vocal cord mobility. No patients required neck dissection or received radiation or chemotherapy. None of the five patients had recurrence after this approach. Conclusions: Laryngeal chondrosarcoma is a rare tumor. Conservative surgical resection remains the mainstay of treatment. The use of an operating microscope can aid in successful resection of laryngeal chondrosarcoma while preserving laryngeal mucosa and function.