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Câncer laríngeo

Última revisão: 23 Sep 2025
Última atualização: 08 Apr 2025

Resumo

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • presença de fatores de risco
  • idade >40 anos
  • rouquidão
  • disfagia
  • odinofagia (deglutição dolorosa)
  • linfadenopatia cervical
  • massa supraglótica ou glótica
  • eritroplasia lesional, ulceração, necrose ou sangramento
  • sinais de obstrução das vias aéreas
  • instabilidade hemodinâmica
Todos los datos

Otros factores de diagnóstico

  • faringite
  • otalgia
  • efusão no ouvido médio
  • estridor
  • perda de peso ou caquexia
  • sofrimento geral
  • massas orofaríngeas ou leucoplasia
  • perda de crepitação laríngea
  • crescimentos na parótida e tireoide
  • murmúrio vesicular diminuído
Todos los datos

Factores de riesgo

  • tabagismo
  • uso de álcool >8 unidades/dia
  • história de radioterapia
  • etnia negra
  • sexo masculino
  • displasia das pregas vocais
  • Doença do refluxo gastroesofágico (DRGE)
  • acloridria
  • história familiar de câncer laríngeo
  • exposição ao Agente Laranja
  • infecção por papilomavírus humano (HPV)
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • tomografia computadorizada (TC) de pescoço com contraste
  • TC de tórax com ou sem contraste
  • RNM com e sem contraste
  • aspiração por agulha fina (AAF) da massa cervical
  • laringoscopia com fibra óptica flexível
Todos los datos

Pruebas diagnósticas que deben considerarse

  • videoestroboscopia rígida
  • laringoscopia direta e rígida
  • teste de imuno-histoquímica
  • biópsia da laringe
  • PET/TC do corpo inteiro
  • endoscopia de fluorescência
Todos los datos

Algoritmo de tratamiento

Agudo

glótico ou supraglótico

subglótico

En curso

tratamento ineficaz/inadequado

Colaboradores

Autores

Matthew Pierce, MD

Otolaryngologist

Otolaryngology, Head and Neck Division

MedStar Washington Hospital Center

Georgetown University

Washington

DC

Disclosures

MP declares that he has no competing interests.

Acknowledgements

Dr Matthew Pierce would like to gratefully acknowledge Dr Scott V. Larson, Dr Hari Deshpande, Dr Elina Kari, Dr Amy Chen, and the late Dr Clarence Sasaki, previous contributors to this topic.

Disclosures

SVL, HD, EK, and AC declare that they have no competing interests.

Peer reviewers

Alfio Ferlito, MD, DLO, DPath, FRCSEd

Director

Department of Surgical Sciences

Professor and Chairman

ENT Clinic

University of Udine

Udine

Italy

Disclosures

AF declares that he has no competing interests.

Steven J. Charous, MD, FACS

Assistant Professor

Department of Otolaryngology

Rush University Medical Center

Chicago

IL

Раскрытие информации

SJC declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

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Основные статьи

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: head and neck cancers [internet publication].Полный текст

Forastiere AA, Ismaila N, Lewin JS, et al. Use of larynx-preservation strategies in the treatment of laryngeal cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2018 Apr 10;36(11):1143-69.Полный текст  Аннотация

American College of Radiology. ACR Appropriateness Criteria: retreatment of recurrent head and neck cancer after prior definitive radiation. 2014 [internet publication].Полный текст

Статьи, указанные как источники

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