More Than a Papilloma: Two Rare Cases of Laryngeal Papillary Squamous Cell Carcinoma - Abstract
Baground: Papillary squamous cell carcinoma (PSCC) is an uncommon variant of laryngeal
squamous cell carcinoma with a distinct exophytic papillary architecture and generally better
prognosis compared to conventional SCC. Although clinical presentation often resembles other
laryngeal malignancies, accurate recognition is essential due to its diagnostic overlap with
benign and other exophytic lesions.
Objective: We report two cases of laryngeal PSCC in elderly male patients presenting
with throat-related symptoms. Endoscopy in Case 1 showed an ulceroproliferative growth on the
lingual surface of the epiglottis, while Case 2 revealed a proliferative lesion involving the pyriform
fossa and aryepiglottic fold. Histopathology in both cases demonstrated papillary fronds with
f
ibrovascular cores lined by dysplastic squamous epithelium. p16 immunohistochemistry showed
diffuse strong positivity in Case 1 and patchy positivity in Case 2, suggesting HPV association.
Result: PSCC may closely mimic squamous papilloma and verrucous carcinoma, especially
in superficial biopsies lacking obvious invasion. Awareness of its characteristic morphology
aids in avoiding misdiagnosis and guides appropriate management. These cases highlight the
importance of considering PSCC in exophytic laryngeal lesions.