Medullary space involvement in laryngeal carcinoma. Computed tomographic demonstration.

The identification of cartilage involvement in laryngeal carcinoma implies advanced stage T4 disease. Although computed tomography (CT) provides the most accurate method of assessing these cartilages, subtle cartilage invasion may go undetected. The major pitfall in detecting tumor involvement is the incomplete calcification of these structures, which may simulate cartilage destruction. High-resolution CT now allows the evaluation of the medullary space of these cartilages. The CT finding of abnormal soft tissue in the central medullary space in addition to a focal cortical defect allows the confident diagnosis of cartilage involvement.