In the course of a laryngoscopic examination for hoarseness, a small lesion is found on the true vocal cord of a 57 year old male smoker. On biopsy, severe squamous dysplasia is noted. If untreated, this lesion may progress to which of the following?

Squamous cell carcinoma is the most frequent type of cancer of the larynx. As with squamous cell carcinoma of the uterine cervix, the development of laryngeal carcinoma is related to an orderly sequence of morphologic changes. These begin with epithelial hyperplasia, proceed through increasingly severe degrees of dysplasia up to in situ carcinoma, and culminate with invasive carcinoma. Cigarette smoking is the most impoant risk factor for the development of laryngeal carcinoma. Adenocarcinoma and mucoepidermoid carcinoma are rare forms of laryngeal cancer. Squamous dysplasia is not a precursor of either type of tumor. Lymphoepithelioma is a form of squamous cell carcinoma that most frequently occurs in the nasopharynx, although it has been repoed in the larynx as well. Its name is derived from the fact that the tumor is rich in lymphocytes. Epstein-Barr virus is implicated in its pathogenesis. Ref: Glick A.B., Dlugosz A.A. (2012). Chapter 111. Chemical Carcinogenesis. In K. Wolff (Ed), Fitzpatrick's Dermatology in General Medicine, 8e.