Which of the following malignancy shows least lymph node involvement:
**Core Concept**
Glottic cancer, also known as vocal cord cancer, is a type of laryngeal cancer that originates from the glottis, which is the part of the larynx (voice box) responsible for voice production. The glottis is divided into three parts: the true vocal cords, the ventricular folds, and the anterior commissure. The lymphatic drainage of the glottis is relatively sparse compared to the supraglottis and subglottis.
**Why the Correct Answer is Right**
Glottic cancer tends to have less lymph node involvement due to its limited lymphatic drainage. The lymphatic vessels in the glottis are less developed, which means that cancer cells are less likely to spread to nearby lymph nodes. This characteristic is a result of the embryological development of the larynx, where the glottis is relatively avascular and has fewer lymphatic vessels. As a result, glottic cancer is often diagnosed at an earlier stage, and its prognosis is generally better compared to other types of laryngeal cancer.
**Why Each Wrong Option is Incorrect**
**Option A:** Supraglottic cancer, which originates from the supraglottis, has a richer lymphatic supply and is more likely to involve lymph nodes due to its anatomical location.
**Option B:** Subglottic cancer, which originates from the subglottis, also has a more extensive lymphatic drainage compared to glottic cancer and is more likely to spread to nearby lymph nodes.
**Option D:** Nasopharyngeal cancer (Ca nasopharynx) is known for its aggressive behavior and high rate of lymph node involvement due to its rich lymphatic supply and proximity to the nasopharyngeal lymphoid tissue.
**Clinical Pearl / High-Yield Fact**
The location of the primary tumor site is a critical factor in determining the prognosis and treatment plan for laryngeal cancer. Glottic cancer, in particular, has a relatively good prognosis due to its limited lymphatic drainage, and early-stage glottic cancer can often be treated with surgery or radiation therapy alone.
**β Correct Answer: C. Glottic cancer**