Malign growths are far less common than benign ones. They comprise both sarcomas and carcinomas. Sarcomas occur in the varieties of spindle-celled, round-celled, giant-celled, mixed-celled, fibrosarcoma, lymphosarcoma, and myxosarcoma. Some attain only the size of small beans, and few exceed the size of a pigeon's egg. The majority of them are primary growths. Most of them originate in the interior of the larynx, whence they may extend by contiguous infiltration, even penetrating the laryngeal walls. The vocal band and the ventricular band are the most frequent seat. The epiglottis is a common seat. These growths appear either in irregular, smooth, spheroid masses, or nodulated, mamillated, and dendritic. They are much the more common in males, and occur chiefly in subjects between the ages of twenty-five and fifty. Their growth is slow for a year or more, and then becomes more rapid. Carcinoma is much more common than sarcoma. It is most frequently primary, and primarily limited to the larynx, but occurs likewise in extension of carcinoma of the tongue, palate, pharynx, oesophagus, or thyroid gland. It rarely extends to the oesophagus or penetrates the laryngeal walls. Squamous-celled carcinoma or epithelioma is the commonest variety, large spheroidal-celled or encephaloid being much less frequent, and small spheroidal-celled and cylindrical-celled occurring still more rarely. Intrinsic {129} laryngeal carcinoma is usually unilateral at first, and most frequently in the left side. Its most frequent seat is at the vocal band. It rarely occurs below this point, and when it does, as in the five cases analyzed by Butlin,[8] it seems to be at some point just beneath. Extrinsic laryngeal carcinoma usually begins in the epiglottis, and sometimes occupies that structure only. It may begin in a cicatrix in the skin.[9] Carcinoma is the more common in males, chiefly in subjects between the ages of fifty and seventy. It has occurred within the first year, at three years, and as late as at eighty-three years. Carcinoma is liable to extend by infiltration of tissue and destroy all the contiguous and overlying tissues, so that it may extend into the pharynx or even externally; the large spheroidal-celled variety presenting the most frequently progressive ulceration into contiguous tissue, and the squamous-celled, intrinsic ulceration. Hemorrhage is frequent. Perichondritis, abscess, necrosis, and fistula take place in old cases. [Footnote 8: _On Malignant Disease of the Larynx_, p. 36, London, 1883.] [Footnote 9: Cohen, _Transactions American Laryngological Association_, p. 113, 1883.]