Pediatric Laryngeal Tumors: A Systematic Review of Benign and Malignant Neoplasms.

BACKGROUND

Pediatric laryngeal tumors are exceptionally rare and encompass a heterogeneous spectrum of benign and malignant neoplasms. Evidence remains largely limited to case reports and small case series.

OBJECTIVE

To systematically characterize the histopathology, clinical presentation, treatment, recurrence, and outcomes of benign and malignant laryngeal tumors in children.

METHODS

A systematic review was conducted according to PRISMA guidelines. MEDLINE, Embase, ScienceDirect, and the Cochrane Library were searched for studies published from January 2000 to July 2026 involving patients aged ≤18 years with histologically confirmed primary laryngeal tumors.

RESULTS

Eighty-six studies were included. Among 52 patients with benign tumors, granular cell tumor was the most frequent diagnosis, followed by neurofibroma and inflammatory myofibroblastic tumor. Hoarseness was the predominant symptom, and surgery, particularly endoscopic resection, was the principal treatment. Recurrence occurred in 7/44 patients (15.9%) with available outcome data. Among 69 patients with malignant or intermediate tumors, squamous cell carcinoma predominated, followed by sarcomas and lymphomas. Treatment included surgery, radiotherapy, and chemotherapy according to histology and disease extent. Total laryngectomy was performed in nine patients, and 12 deaths were reported.

CONCLUSIONS

Pediatric laryngeal tumors are rare, but should be considered in children with persistent or progressive hoarseness, dyspnea, dysphagia, or other unexplained upper airway symptoms. Granular cell tumor and neurofibroma were the predominant benign lesions, whereas squamous cell carcinoma was the most frequently reported malignant neoplasm. Given the rarity of these tumors and the current reliance on case-based evidence, the establishment of international multicenter registries is warranted to generate higher-quality data and inform standardized diagnostic and therapeutic algorithms for pediatric laryngeal neoplasms.