Intracranial metastasis in carcinoma of the glottis

Abstract

1Glottic carcinoma rarely metastasises because the glottis is sparsely served by lymphatic and blood vessels. We report a rare case of multiple intracranial metastasis in a patient with locoregionally controlled glottic carcinoma who did not show any evidence of distant metastasis in other sites or second primary lesions. In January 1994, a 40-year-old woman presented to our clinic with a 2-year history of hoarseness and breathing discomfort. Direct laryngoscopy revealed a papillomatous growth involving both true vocal cords, which extended to the anterior commissure and into the subglottis. The left cord was fixed. Histopathology revealed that the growth was a squamous-cell carcinoma with no involvement of the cervical lymph nodes and no distant metastasis. A CT of the neck confirmed the laryngoscopy findings. There was no evidence of invasion of thyroid cartilage or of cervical lymph-node metastasis (figure 1). The patient was subsequently diagnosed as having glottic carcinoma, stage T3N0M0 (according to the American Joint Committee on Cancer Staging Manual 1992) and was treated with 66 Gy phased, external radiotherapy delivered by a parallel, opposed, two-field technique. After treatment was completed, she remained asymptomatic with locoregional control of disease for 8 years.