Laryngeal Mass
A laryngeal mass is an abnormal growth or lesion involving the larynx, commonly known as the voice box. The larynx contains the vocal cords and plays a critical role in speaking, breathing, and protecting the airway during swallowing. Laryngeal masses may be benign or malignant and can result from inflammation, infection, vocal strain, cysts, polyps, or tumors. Because the larynx is directly involved in voice production and airway function, even relatively small lesions can produce noticeable symptoms.
What is it?
The larynx is located in the front of the neck between the throat and the trachea (windpipe). It contains the vocal cords and helps regulate speech, breathing, and airway protection during swallowing.
The larynx is divided into three major regions:
Supraglottis: above the vocal cords
Glottis: the vocal cords themselves
Subglottis: below the vocal cords
Masses may develop in any of these regions, and the exact location often influences symptoms, imaging appearance, and treatment options.
Benign laryngeal lesions are common and include vocal cord nodules, polyps, cysts, granulomas related to reflux or prior intubation, and papillomas that may be associated with human papillomavirus (HPV).
Inflammatory conditions, infections, and swelling related to vocal overuse may also produce mass-like findings.
Malignant tumors of the larynx are most commonly squamous cell carcinomas and are strongly associated with smoking, heavy alcohol use, certain occupational exposures, and HPV infection.
Because the vocal cords are highly sensitive to structural changes, persistent hoarseness is often the earliest symptom of a laryngeal lesion and should not be ignored.
Evaluation usually begins with direct visualization of the larynx using laryngoscopy performed by an ENT specialist.
Imaging becomes especially important when a mass is identified, when symptoms persist despite treatment, or when there is concern for spread beyond the larynx.
MRI of the neck with contrast provides detailed evaluation of soft tissues, vocal cord involvement, surrounding muscles, and spread into nearby structures.
CT of the neck with contrast is particularly useful for evaluating cartilage involvement, airway narrowing, calcifications, and lymph node enlargement.
PET/CT may be used in selected cases for staging or monitoring confirmed laryngeal cancers.
Biopsy is generally required to establish a definitive diagnosis when malignancy is suspected.
Important to Know
Treatment depends on the type, size, and location of the laryngeal mass.
Many benign vocal cord lesions improve with voice rest, speech therapy, smoking cessation, and treatment of contributing conditions such as acid reflux.
Some benign lesions may require minimally invasive surgical removal performed by an ENT specialist.
When imaging or biopsy suggests cancer, care is typically coordinated through a multidisciplinary head and neck oncology team and may involve surgery, radiation therapy, chemotherapy, or combinations of these treatments.
Preserving voice quality, swallowing function, and airway stability is often a major consideration during treatment planning.
Persistent hoarseness lasting more than three to four weeks—especially in adults with smoking or alcohol exposure—should be medically evaluated rather than attributed solely to a lingering infection.
Follow-up imaging may be recommended to monitor treatment response or recurrence.
Red flag symptoms include hoarseness lasting more than several weeks, breathing difficulty, noisy breathing, coughing up blood, severe swallowing difficulty, sudden voice loss, unexplained weight loss, or a new neck lump. These symptoms require prompt medical evaluation.