Childhood Laryngeal Tumors (PDQ®): Treatment - Patient Information [NCI]

What are childhood laryngeal tumors?

Childhood laryngeal tumors form in the voice box, also called the larynx. These tumors may be benign (which means they are not cancer) or cancer. Most laryngeal tumors in children are not cancer and do not spread to other tissues. Both types of tumors need treatment.

The most common type of benign laryngeal tumor is papillomatosis of the larynx. In this condition, papillomas (benign tumors that look like warts) form in the lining of the larynx. These tumors may block the airway and cause trouble breathing. They often come back after treatment and, in rare cases, may turn into cancer in the larynx or the lung.

The larynx is a part of the throat, between the base of the tongue and the trachea (windpipe). The larynx contains the vocal cords, which vibrate and make sound when air is directed against them. The sound echoes through the pharynx, mouth, and nose to make a person's voice.

There are three main parts of the larynx:

• The supraglottis is the upper part of the larynx above the vocal cords, including the epiglottis.
• The glottis is the middle part of the larynx where the vocal cords are located.
• The subglottis is the lower part of the larynx between the vocal cords and the trachea.

Anatomy of the larynx. The larynx is a part of the throat, between the base of the tongue and the trachea. The three main parts of the larynx are the supraglottis (including the epiglottis), the glottis (including the vocal cords), and the subglottis.

Causes of childhood laryngeal tumors

Laryngeal cancer in children is caused by certain changes to the way cells in the larynx function, especially how they grow and divide into new cells. Often, the exact cause of these cell changes is unknown. To learn more about how cancer develops, see What is Cancer?

Laryngeal papillomatosis is caused by infection with low-risk HPV (human papillomavirus), most often types 6 and 11. Children can get the HPV infection that causes laryngeal papillomatosis from an infected mother during birth. Most children with an HPV infection do not develop laryngeal papillomatosis. Talk with your child's doctor if you think your child may be at risk.

Getting the HPV vaccine can help protect against HPV infection and reduce the risk of transmitting it during childbirth. Learn more about HPV vaccines.

Symptoms of childhood laryngeal tumors

Children may not have symptoms of a laryngeal tumor until the tumor has grown bigger. It's important to check with your child's doctor if your child has:

• hoarseness or a change in the voice
• trouble or pain when swallowing
• trouble breathing
• a high-pitched sound with breathing
• a lump in the neck or throat
• a sore throat
• a cough that does not go away

Infants and young children with these tumors may grow slowly, and not eat well or meet developmental milestones such as sitting, walking, and talking in sentences.

These symptoms may be caused by problems other than a laryngeal tumor. The only way to know is to see your child's doctor.

Tests to diagnose childhood laryngeal tumors

If your child has symptoms that suggest a laryngeal tumor, their doctor will need to find out if these are due to cancer or some other problem. The doctor will ask when the symptoms started and how often your child has been having them. They will also ask about your child's personal and family medical history and do a physical exam. Based on these results, the doctor may recommend other tests. If your child is diagnosed with a laryngeal tumor, the results of these tests will help you and your child's doctor plan treatment.

The tests used to diagnose laryngeal tumors may include:

Oral exam

In an oral exam, a doctor or dentist checks the mouth for abnormal areas. This exam may be done while under anesthesia. The doctor or dentist will feel the entire inside of the mouth with a gloved finger and examine the area with a small long-handled mirror and lights or a fiberoptic device.

Neck and chest x-ray

An x-ray is a type of radiation that can go through the body and make pictures of the inside of the body. A neck and chest x-ray makes pictures of the organs and bones inside the neck and chest.

Magnetic resonance imaging (MRI)

MRI uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas of the body, such as the head and neck. This procedure is also called nuclear magnetic resonance imaging (NMRI).

CT scan (CAT scan)

A CT scan uses a computer linked to an x-ray machine to make a series of detailed pictures of areas inside the body. The pictures are taken from different angles and are used to create 3-D views of tissues and organs. A dye may be injected into a vein or swallowed to help the tissues or organs show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. Learn more about Computed Tomography (CT) Scans and Cancer.
Computed tomography (CT) scan of the head and neck. The child lies on a table that slides through the CT scanner, which takes a series of detailed x-ray pictures of the inside of the head and neck.

PET scan (positron emission tomography scan)

A PET scan uses a small amount of radioactive sugar (also called radioactive glucose) that is injected into the vein. Then a scanner is used to make detailed, computerized pictures of areas inside the body where the glucose is taken up. Because cancer calls often take up more glucose than normal cells, the pictures can be used to find cancer cells in the body.
Positron emission tomography (PET) scan. The child lies on a table that slides through the PET scanner. The head rest and white strap help the child lie still. A small amount of radioactive glucose (sugar) is injected into the child's vein, and a scanner makes a picture of where the glucose is being used in the body. Cancer cells show up brighter in the picture because they take up more glucose than normal cells do.

Ultrasound

Ultrasound exam uses high-energy sound waves (ultrasound) that bounce off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.

Barium swallow

Barium swallow is a series of x-rays of the esophagus and stomach. For this procedure, the patient drinks a liquid that contains barium (a silver-white metallic compound). The barium coats the esophagus and stomach which helps them show up more clearly in x-rays. This procedure is also called an upper GI series.

Biopsy

A biopsy is a procedure in which a sample of tissue is removed from the tumor so that a pathologist can view it under a microscope to check for signs of disease, such as cancer or laryngeal papillomatosis.

The sample of tissue may be removed during a procedure such as:

• Laryngoscopy is a procedure in which the doctor checks the larynx (voice box) with a mirror or a laryngoscope to check for abnormal areas. A laryngoscope is a thin, tube-like instrument with a light and a lens for viewing the inside of the throat and voice box. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of disease.
• Endoscopy is a procedure to look at organs and tissues inside the body, such as the throat, esophagus, and trachea to check for abnormal areas. An endoscope is a thin, lighted tube with a light and a lens for viewing that is inserted through an opening in the body, such as the mouth. A special tool on the endoscope may be used to remove samples of tissue.

Human papillomavirus (HPV) test

An HPV test checks tissue samples from the biopsy for certain types of HPV infection that may be linked to laryngeal papillomatosis.

Immunohistochemistry

An immunohistochemistry test measures antibodies to check for certain antigens (markers) in a sample of a patient's tissue. The antibodies are usually linked to an enzyme or a fluorescent dye. After the antibodies bind to a specific antigen in the tissue sample, the enzyme or dye is activated, and the antigen can then be seen under a microscope. This type of test is used to help diagnose cancer and to help tell one type of cancer from another type of cancer.

Getting a second opinion

You may want to get a second opinion to confirm your child's cancer diagnosis and treatment plan. If you seek a second opinion, you will need to get medical test results and reports from the first doctor to share with the second doctor. The second doctor will review the pathology report, slides, and scans. This doctor may agree with the first doctor, suggest changes to the treatment plan, or provide more information about your child's cancer.

To learn more about choosing a doctor and getting a second opinion, see Finding Cancer Care. You can contact NCI's Cancer Information Service via chat, email, or phone (both in English and Spanish) for help finding a doctor or hospital that can provide a second opinion. For questions you might want to ask at your child's appointments, see Questions to Ask Your Doctor About Cancer.

Treatment of childhood laryngeal tumors

Who treats children with laryngeal tumors?

A pediatric oncologist, a doctor who specializes in treating children with cancer, oversees treatment of laryngeal tumors. The pediatric oncologist works with other health care providers who are experts in treating children with cancer and who specialize in certain areas of medicine. Other specialists may include:

• pediatrician
• pediatric surgeon
• radiation oncologist
• pathologist
• ear, nose, and throat specialist
• social worker
• rehabilitation specialist
• psychologist
• child-life specialist

There are different types of treatment for children with laryngeal tumors. You and your child's care team will work together to decide on treatment. Many factors will be considered, such as your child's overall health and whether the tumor is newly diagnosed or has come back.

Your child's treatment plan will include information about the tumor, the goals of treatment, treatment options, and the possible side effects. It will be helpful to talk with your child's care team before treatment begins about what to expect. For help every step of the way, see our booklet, Children with Cancer: A Guide for Parents.

Treatment of childhood laryngeal cancer

Laser surgery uses a laser beam (a narrow beam of intense light) to destroy the cancer cells.

For laryngeal cancer that is likely to spread, external radiation therapy is also used. This treatment uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. Learn more about External Beam Radiation Therapy for Cancer and Radiation Therapy Side Effects.

If the cancer comes back after treatment, your child's doctor will talk with you about what to expect and possible next steps. There might be treatment options that may shrink the cancer or control its growth. If there are no treatments, your child can receive care to control symptoms from cancer so they can be as comfortable as possible.

Treatment of childhood laryngeal papillomatosis

Laser surgery, which uses a laser beam (a narrow beam of intense light) to destroy cancer cells, may be used to treat newly diagnosed papillomatosis or other benign tumors.

For laryngeal papillomatosis that comes back after being removed by laser surgery four times in one year, treatment may include:

• Immunotherapy. Immunotherapy uses the patient's immune system to fight disease.
• Laser surgery combined with targeted therapy. Targeted therapy uses drugs or other substances to block the action of specific enzymes, proteins, or other molecules involved in the growth and spread of cancer cells.

Clinical trials

Joining a clinical trial may be an option. There are different types of clinical trials for childhood cancer. For example, a treatment trial tests new treatments or new ways of using existing treatments. Supportive care and palliative care trials look at ways to improve quality of life, especially for those who have side effects from cancer and its treatment.

You can use the clinical trial search to find NCI-supported cancer clinical trials that are accepting participants. The search allows you to filter trials based on the type of cancer, your child's age, and where the trials are being done.

Learn more about Clinical Trials Information for Patients and Caregivers.

Follow-up care

As your child goes through treatment, they will have follow-up tests or check-ups. Some of the tests that were done to diagnose the cancer may be repeated to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.

Some of these tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your child's condition has changed or if the cancer has come back.

Coping with your child's cancer

When your child has cancer, every member of the family needs support. Taking care of yourself during this difficult time is important. Reach out to your child's treatment team and to people in your family and community for support. To learn more, see Support for Families When a Child Has Cancer and the booklet Children with Cancer: A Guide for Parents.

Related Resources

For more childhood cancer information and other general cancer resources, see:

• Head and Neck Cancer Home Page
• Immunotherapy to Treat Cancer
• Targeted Therapy to Treat Cancer
• About Cancer
• Childhood Cancers
• CureSearch for Children's Cancer
• Late Effects of Treatment for Childhood Cancer
• Adolescents and Young Adults with Cancer
• Cancer in Children and Adolescents
• For Survivors and Caregivers

About This PDQ Summary

About PDQ

Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.

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Purpose of This Summary

This PDQ cancer information summary has current information about the treatment of childhood laryngeal cancer and papillomatosis. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

Reviewers and Updates

Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.

The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Pediatric Treatment Editorial Board.

Clinical Trial Information

A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

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PDQ® Pediatric Treatment Editorial Board. PDQ Childhood Laryngeal Tumors. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/types/head-and-neck/patient/child/laryngeal-treatment-pdq. Accessed <MM/DD/YYYY>.

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Last Revised: 2024-09-17

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