There is not a lobular pattern but a zone of transition from a fibroblast periphery to elastic cartilage is present. Radiotherapy and chemotherapy are of little value in the treatment plan. The choice of initial surgery is often difficult but should be based on the site, size, and grade of the lesion. Small lesions of the arytenoid and epiglottis can be removed endoscopically. Thyroid cartilage lesions may be removed through an extralaryngeal approach.
All major series recommend a conservative attitude because salvage laryngectomy provides a cure.
In conclusion, cartilaginous lesions of the larynx are rare lesions that pose many diagnostic and therapeutic challenges. Fortunately even the most aggressive lesions are rare and the lower grade lesions curable. As always, keeping the patient in mind as regards to age, lifestyle, and willingness to undergo multiple surgical procedures possibly emergent in the face of life threatening airway compromise is critical. Caution should be taken not to underestimate these lesions. Seven cases have been reported to date using stents, rib grafts and an epiglottic flap.