Mechanisms of tumor invasion in the laryngeal structure. A study of undecalcified thin sections
Hörmann, K.; Donath, K.
Laryngologie Rhinologie Otologie 65(5): 297-302
1986
ISSN/ISBN: 0340-1588 PMID: 3526057 Document Number: 274460
Mechanisms of invasion of squamous cell carcinoma into the framework of the larynx were studied in nondecalcified acrylic embedded tissue. Destruction was always an indirect process mediated by giant cells or proteases. Two different stages of tissue specific response were seen. Bone was reacting with osteoneogenesis in the interface and with apposition of bone at the tumour non-attached side. Hyaline cartilage was responding with new formation of bone distant to the tumour and with production of protease inhibiting cartilage substance, whenever the tumour was attached to cartilage directly. Macrophages resorbed the product of these local tumour-host-interactions. There were plasma cells indicating a local immunological activity. In cases of irradiated carcinomatous larynxes this local immunological process seemed to be not in action. Here tumour invaded the skeleton of the larynx directly and microphages were seen removing the waste of destruction showing sequesters of cartilage and bone. These findings confirm the therapeutic principle that in carcinomas infiltrating the framework of the larynx irradiation is insufficient. Irradiation disarranges the specific local mechanism of defence and advances destruction and metastases by the tumour. Therefore, if operative treatment is not possible, it must be discussed, whether an alternative palliative proceeding--for example endolaryngeal reduction of tumour masses by laser surgery conservating the laryngeal framework--is a more adequate solution.