CT scan to evaluate thyroid cartilage invasion can be indicated for patients with anterior commissure involvement. Order CT scan in patients with vocal cord impairment or fixation. Perform a careful head and neck examination. Panendoscopy to rule out synchronous malignancy in the head and neck, tracheobronchial tree, and esophagus is controversial, but should be performed. The author also recommends preoperative and postoperative videostroboscopy and voice recording for functional assessment and documentation.
Histology is usually squamous cell carcinoma arising from dysplasia.
Minor salivary carcinomas, such as adenocarcinoma, also rarely occur. Sarcomas are extremely rare. Granular cell tumors, plasmacytoma, and lesions resembling malignancy should be considered. Small cell carcinoma and other neuroendocrine tumors also rarely occur. Clinical trials of various chemoprevention agents for laryngeal premalignancy are ongoing.