The Incidence of Premalignant and Malignant Disease in Reinke's Edema

Abstract

Objectives: Reinke’s Edema is a benign lesion of the vocal folds affecting the subepithelial space. This condition occurs almost exclusively in moderate to heavy smokers. As part of a study of the management of Reinke’s Edema, we aimed to determine the prevalence of dysplasia and malignancy in histologically proven Reinke’s Edema. Methods: A retrospective analysis of all laryngeal biopsies performed in North Glasgow, United Kingdom, between 2001 and 2010 was carried out through the North Glasgow Pathology Database. Clinical and pathological data from all patients with histologically confirmed Reinke’s Oedema were recorded with specific respect to the reporting of dysplasia and malignancy. Results: From the 10 year cohort, a total of 3902 laryngeal biopsies were performed. 190 patients (19 males and 171 females) had histologically proven Reinke’s Edema. Of this cohort, the pathologist commented on dysplasia in 172 (91%) of patients. The remaining 18 (9%) patients subsequently had their pathology reviewed. In the 190 patients who had Reinke’s Edema, 13 (8%) patients had mild dysplasia, 2 (1%) had moderate dysplasia, and 1 (0.5%) had severe dysplasia. There was no malignancy reported in the cohort. Conclusions: In our predominantly female smoking population, the epithelium appears to differentiate to benign Reinke’s Edema rather than malignancy. Patients can be reassured with regard to the very low risk of malignancy in classical Reinke’s Edema. The principle indication for surgical intervention should be the patient’s desire to improve their voice.