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Clinical Problems of Hypopharygeal Carcinomas


Authors: L. Černý;  M. Eber;  R. Černý
Authors‘ workplace: ORL oddělení nemocnice Karviná-Ráj primář MUDr. M. Eber
Published in: Otorinolaryngol Foniatr, 56, 2007, No. 3, pp. 165-172.
Category: Comprehensive Reports

Overview

The authors refer comprehensively and systematically to clinical manifestations, diagnostic approaches and effects of therapeutic modalities in view of prognosis of hypopharyngeal carcinomas. Three case reports exemplify their experience with surgical treatment of the disease.

The first patient suffered from carcinoma of the piriform sinus infiltrating the left pharyngeal wall.. It was removed within the framework of TLE and partial PHE. Enlarged cervical nodes removed during bilateral block dissections were bilaterally affected by metastases. After almost two year time lapse the patient died due to bronchopneumonia. No signs of malignoma activation were evident.

The same kind of tumor in the second patient having originated in the left lateral pharyngeal wall was removed during lateral pharyngotomy. The patient happily survives two years without signs of tumor activation in a good health state.

The third patient also suffered from an extended size of carcinoma of the left lateral pharyngeal wall and larynx with adjacent portion of hypopharynx has to be sacrificed. Metastases were discovered only ipsilaterally similar to the previous patient. The patient survives five years after the surgery in a good health state.

The communication is intended to address a broader professional public. It draws attention to serious prognosis of this kind of malignoma at the fork of respiratory and alimentary pathways. It is caused by unmanageable metastases of the disease in regional and distant lymphatic nodes. The expectations of the affected patients lay in the area of sentinel nodes. If the positive radioactive nodes are removed in time there is a real chance to improve the prognosis of in HPC categories, especially those classified as T3N1 with the exception of T4N2-3. The following development of the method hopefully shows, whether the expectations are not undue.

Key words:
hypopharyngeal carcinomas, metastases, prognosis.


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