Explanation

Malignant tumors of the larynx can spread through multiple pathways, including:

1. Lymphatic channel: The most common route of metastasis for laryngeal cancer is the lymphatic system.
2. Nerve: Perineural invasion can occur, although it is less common than lymphatic spread.
3. Blood: Hematogenous spread (through the bloodstream) can occur, leading to distant metastases.
4. Direct spread to distant structures: Laryngeal cancer can directly invade adjacent structures such as the thyroid, esophagus, and neck muscles