PP120: Synchronous appearance of metastasis of squamous-cell laryngeal carcinoma and papillary carcinoma of thyroid gland in the one neck lymphonode

Abstract

Purpose In less than hundred cases were published until now synchronous appearance of squamous-cell and papillary carcinoma metastases within neck lymphonodes. In this presentation metastases of these cancers were detected within only one lymphonode. Material and methods At 72 years old man with subglottic laryngeal carcinoma and colloid thyroid nodule were performed total laryngectomy and thyroidectomy with bilateral selective neck dissection. Histologically was diagnosed laryngeal squamous-cell carcinoma (T4N0M0) and colloid thyroid gland goiter. After eight months one lymphonode on the neck left side was extirpated. Microscopical in one part of lymphonode it was found atypical squamous epithelium with extensive keratinization which corresponded to squamous-cell carcinoma and in the other part tissue composed of loose and edematous villi, partly fibrovascular stroma with atypical epithelial cells, such as ground-glass nuclei with visible notches corresponding to thyroid papillary carcinoma. The patient died 19 months after the first surgery. Results Head and neck squamous-cell carcinomas commonly occurring synchronously with well-differentiated thyroid cancer with the incidence of 5–12%. We have shown that it is possible synchronous occurrence of different metastatic cells within a single lymphonode. Most commonly affected are men ages between 50 and 60 years, exposed to risky behavior. In the symptomatology usually dominate symptoms related to advanced squamous-cell carcinoma of the head and neck, while thyroid gland cancers symptoms are usually subclinical. The co-occurrence of two different cancers metastases in lymphonodes is negative prognostic sign. Five-year survival of these patients was 41% usually determined by complications of the laryngeal cancer. Conclusions To consider the possibility of simultaneous occurrence of cancers of the larynx and thyroid gland is advisable during diagnostic evaluation of patients with laryngeal cancer to make thyroid gland evaluation in order to avoid repeated surgery.