Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
182 Doctors are Online

Have posterior vocal process granuloma caused by reflux. What are the chances of this granuloma being a malignant lesion?

User rating for this question
Very Good
Answered by

ENT Specialist
Practicing since : 2001
Answered : 2339 Questions
Question
I was told that I have a small posterior vocal process granuloma probably caused by reflux and constantly trying to clear my throat. What are the chances of this granuloma being a malignant lesion. Is clinical diagnoses pretty reliable.
I quit smoking 15 years ago.
I was told to return in a month following treatment for reflux.
Do you think I may need a biopsy. I think you answered my previous question on this,however I would like to know if this finding could lead to other issues with the larynx such as cancer.
Posted Sat, 21 Jul 2012 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Naveen Kumar 3 hours later

Hi

Thanks for the query

1. What are the chances of this granuloma being a malignant lesion?
A: With regards to the past history of smoking, your age and the acid reflux, the probability of granuloma turning malignant is approximately 25-30%.

2. Is clinical diagnoses pretty reliable?
A: Yes, if the granuloma has been identified after doing a scopy of the larynx, it is reliable.

3. I was told to return in a month following treatment for reflux.
A: If the grauloma is secondary to the acid reflux disease, it will reduce in size after taking the medicines. If it does not, then the biopsy of the same is advisable to rule out malignancy.

4. However I would like to know if this finding could lead to other issues with the larynx such as cancer?
A: As I mentioned in the first answer, considering the predisposing factors, the chances of malignancy cannot be ruled out. But, it is better to try with medications for acid reflux and then go ahead with further investigations.

Hope I have answered your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
 
Follow-up: Have posterior vocal process granuloma caused by reflux. What are the chances of this granuloma being a malignant lesion? 29 minutes later
The ENt specialist that scoped me told me that he believes it's benign based on how it appears clinically. So you suggest that it
may still be a malignant lesion?My point is how reliable is clinical diagnoses in this case.?Is 20to30 % chance pretty high even though clinically it looks benign?
And if I didn't have any pathology present such as this granuloma would you still believe the chances of malignancy about 20 to 30% with my past history and reflux or the finding of granuloma is a predictor of future problems with laryngeal cancer.
 
 
Answered by Dr. Naveen Kumar 2 hours later

Hi

Thanks for writing back

1. So you suggest that it may still be a malignant lesion?
A: Even though vocal cord granulomas are benign in nature, owing to the predisposing factors, a possibility of malignancy cannot be ruled out. It would be wiser to take the necessary medicines such as proton pump inhibitor and prokinetic for the treatment of the same. Wait and watch for a month, if it does not relieve then you will require a biopsy of the lesion, to confirm it is benign.

2. My point is how reliable is clinical diagnoses in this case?
A: As you don't have any other features of malignancy (such as hoarseness, difficulty in breathing and weight loss) this lesion has to be initially considered as benign and treated accordingly.

3. Is 20to30 % chance pretty high even though clinically it looks benign?
A: Yes, the percentage of malignant transformation is definitely high even though the lesion looks benign.

4. If I didn't have any pathology present such as this granuloma would you still believe the chances of malignancy about 20 to 30% with my past history and reflux or the finding of granuloma is a predictor of future problems with laryngeal cancer.
A: Not all smokers will land up in malignancy until they have any identifiable lesions. The chances of malignancy are about 20-30% with the identification of the granulomatous lesion.

Usually, for smokers, the risk of the development of laryngeal cancer decreases after the cessation of smoking, but remains elevated even years later when compared to that of nonsmokers. In USA, the incidence is five in 100,000.

Wish you good health.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
 
Follow-up: Have posterior vocal process granuloma caused by reflux. What are the chances of this granuloma being a malignant lesion? 30 minutes later
Doctor
Where do you practice Ent specialty.
What hospital are you affiliated with
Thanks.
 
 
Answered by Dr. Naveen Kumar 17 hours later
Hi,

I am currently practicing in Oman.

You may find my further details at this link.

WWW.WWWW.WW
Regards,
Above answer was peer-reviewed by
 
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Medical Procedures
Medical Topics

The user accepted the expert's answer

Ask an ENT Specialist

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor