Differentiated liposarcoma is a rare connective tissue malignancy in adults that mostly occurs in the extremities and retroperitoneum, with a tendency to aggressiveness and recurrence, and the ten-year survival rate of about 10%. Clinically, dedifferentiated liposarcoma of the pharynx has been reported to be rare abroad and only one case has been reported in China. Clinical symptoms are mainly foreign body sensation in the pharynx, which can be easily misdiagnosed as benign tumors. Pathological diagnosis is the main examination tool for this kind of disease, and immunohistochemistry and FISH test can help to differentiate it from other tumors. This article presents a case of a male patient with dedifferentiated liposarcoma of the hypopharynx, who had a foreign body sensation in the pharynx for more than 1 month, and underwent supported laryngoscopic pharyngeal lesion resection after completing the preoperative relevant examinations and postoperative radiation therapy, with postoperative pathology returned as dedifferentiated liposarcoma. The present postoperative follow-up was 12 months without recurrence. Therefore, accurate diagnosis and timely treatment are extremely important for the prognosis of this disease.
Humans ; Male ; Liposarcoma/diagnosis* ; Hypopharyngeal Neoplasms/diagnosis* ; Middle Aged ; Hypopharynx ; Adult

Esophageal Neoplasms/diagnosis* ; Esophagus ; Humans ; Hypopharyngeal Neoplasms ; Hypopharynx ; Neoplasms, Multiple Primary

Hypopharyngeal cancer and esophageal cancer often occur synchronously or metachronously. Timely screening, diagnosis and individual treatment are important to improve the prognosis of patients. At present, there is no clinical guideline or consensus in this cross-cutting area in China, and there is a need of consistent diagnosis and treatment recommendation for these patients. Under the sponsorship of the Committee of Esophageal Cancer in China Anti-Cancer Association, the Chinese Working Group on Cooperative Diagnosis and Treatment of Hypopharyngeal and Esophageal Cancer was established by domestic experts in the fields of otolaryngology head and neck surgery, radiation oncology, and gastrointestinal endoscopy. This consensus document on multiple primary cancers (simultaneous or metachronous) of the hypopharynx and esophagus was developed through literature review, collective experience and expert discussions. The goals of the consensus include: (1) raising concern for this cross-cutting field; (2) establishing a preliminary clinical diagnosis and treatment recommendation; (3) preparing for the establishment of future high-level guidelines through standardized clinical practice.
China ; Consensus ; Esophageal Neoplasms ; diagnosis ; therapy ; Humans ; Hypopharyngeal Neoplasms ; diagnosis ; therapy ; Neoplasms, Multiple Primary ; diagnosis ; therapy ; Neoplasms, Second Primary ; diagnosis ; therapy ; Prognosis

OBJECTIVE: Study the clinical characteristics, treatment results and prognostic factors of hypopharyngeal carcinoma. MMETHOD: A retrospective analysis was performed of 97 hypopharyngeal cases that were treated in Department of Dtolaryngology of our hospital from January 2008 to December 2012. 93 cases of them are male patients, and 4 cases are female patients. The tumors are originated from pyriform sinus(75 cases), posterior pharyngeal wall (16 cases) and post-cricoid area (6 cases). Of the 97 patients,21 patients were treated with partial hypopharynx resection (21. 6%), 7 were treated with partial laryngectomy+ partial hypopharynx resection (7. 2%), 53 were treated with total laryngectomy+partial hypopharynx resection (54. 6%), 12 were treated with total laryngectomy and total hypopharynx resection, gastric-pharyngeal anastomosis (12. 4%) and 4 were treated with total laryngectomy and total hypopharynx resection, enteric-pharyngeal anastomosis (4. 1%). Sixty-one cases undergo postoperative radiotherapy in Oncology. Use Chi-square test to do enumeration data analysis, the survival rate is calculated with the life table method, survival analysis with Kaplan-Meier method, parallel Log-rank test. Cox regression multivariate analysis model is used to find the factors affecting prognosis. RESULT: The follow-up rate of this group was 90. 7%. All patients' 1-year survival rate is 76. 0% , 3-year survival rate is 56. 0%, pathological lymph node metastasis rate is 71. 1%, occult lymph node metastasis rate is 19. 6%. Local recurrence rate is 21. 6%. The main reasons of death in patients include : cervical lymph node metastasis in 7 patients (21. 9%), local recurrence in 12 cases (37. 5%), distant metastases in 10 patients (31. 3%) and so on. Univariate analysis showed that tumor size (P<0. 01) and tumor T stage (P<0. 05) have impact on survival prognosis, no risk factors was found with Cox regression multivariate analysis. CONCLUSION Hypopharyngeal carcinoma is difficult to be found early, prone to recurrence and metastasis after operation, carefully chosen surgical excision and neck dissection, adjuvant postoperative radiation therapy is the main treatment strategy. Posterior pharyngeal wall carcinoma tend to have higer recurrence and metastasis rate than the other two types of hypopharyngeal caocinom, and treatment would cause much larger injury, so more attention should be paid to this type of hypopharyngeal caocinom.
Carcinoma, Squamous Cell ; diagnosis ; surgery ; Female ; Head and Neck Neoplasms ; diagnosis ; surgery ; Humans ; Hypopharyngeal Neoplasms ; diagnosis ; surgery ; Hypopharynx ; surgery ; Laryngectomy ; Lymphatic Metastasis ; Male ; Neck Dissection ; Neoplasm Recurrence, Local ; Pharynx ; Prognosis ; Retrospective Studies ; Squamous Cell Carcinoma of Head and Neck ; Survival Rate ; Treatment Outcome

OBJECTIVE: By studying the MRI apperances of postcricoid area invaded by laryngeal carcinoma, to identify the characteristic appearances of the invaded postcricoid area and to provide information on the early detection of the lesions. METHOD: Eighteen cases of MRI images of postcricoid area invaded by laryngeal carcinoma were included in this study. To find out the characteristic manifestation of the lesions, the destructions of surrounding structures and layers, and the invaded extent were observed. RESULT: In 18 cases the invaded lesions of postcricoid area include the mucous layer, submucous fat layer and the mucous layer of anterior wall. In 14 cases the invaded lesions of postcricoid area include the mucous layer, submucous fat layer and the mucous layer of the posterior wall. The soft tissue mass was found in 15 cases, and disappeared hypopharynx cavity in 16 cases. In 14 cases, the full-thickness of both anterior and posterior walls were invaded, accompanied with soft tissue mass and disappeared hypopharynx cavity. CONCLUSION The postcricoid area invaded by laryngeal carcinoma usually shows the destruction of normal structures, signal change in MRI and soft tissue mass. Being familiar with the imaging of the invaded postcricoid area is extremely important to early detect laryngeal carcinomas invading postcricoid area.
Cricoid Cartilage ; pathology ; Humans ; Hypopharyngeal Neoplasms ; diagnosis ; Hypopharynx ; pathology ; Laryngeal Neoplasms ; diagnosis ; Larynx ; pathology ; Magnetic Resonance Imaging

OBJECTIVETo explore the relationship between positive lymph node number, involved region, positive lymph node ratio and the prognosis of patients with hypopharyngeal cancer.

METHODSClinicopatological data of 81 patients with hypopharyngeal squamous cell carcinoma who underwent hypopharyngectomy and cervical lymph node dissection from January 2000 to December 2005 in our hospital were analyzed retrospectively. The relationship between positive lymph node number, involved region, positive lymph node ratio and the prognosis was analyzed.

RESULTSThe rate of lymph node metastasis was 79.0% (64/81) in the 81 patients with hypopharyngeal cancer. Of which, the rates of unilateral metastasis and bilateral metastasis were 82.9% (53/64) and 17.1% (11/64), respectively. The rate of lymph node metastasis was increasing with advancing tumor stage. The median survival times were 81, 51 and 26 months in the patients with 0, 1-3 and ≥ 4 positive lymph nodes, respectively (P < 0.001), 84, 45 and 23 months in patients with 0, 1-2 and ≥ 3 involved regions, respectively (P < 0.001), and 84, 51 and 17 months in patients with positive lymph node ratio of 0, <10% and ≥ 10%, respectively (P < 0.001). Multivariable analysis showed that positive lymph node ratio, extracapsular infiltration, T classification and treatment modality were independent prognostic factors (P = 0.002).

CONCLUSIONSPositive lymph node ratio is an independent prognostic factor for hypopharyngeal cancer.

Carcinoma, Squamous Cell ; diagnosis ; Head and Neck Neoplasms ; diagnosis ; Humans ; Hypopharyngeal Neoplasms ; diagnosis ; Lymph Node Excision ; Lymph Nodes ; surgery ; Lymphatic Metastasis ; diagnosis ; Prognosis ; Retrospective Studies

Adult ; Humans ; Hypopharyngeal Neoplasms ; diagnosis ; Hypopharynx ; pathology ; Male

Adult ; Esophageal Neoplasms ; diagnosis ; Humans ; Hypopharyngeal Neoplasms ; diagnosis ; Male ; Sarcoma, Synovial ; diagnosis

OBJECTIVETo investigate the value of narrow band imaging (NBI) endoscopy in the detection of unknown primary tumor site with cervical lymph node metastases of squamous cell carcinoma.

METHODSFifty-three patients with cervical lymph node metastases of squamous cell carcinoma treated in our department between June 2009 and December 2011 were enrolled in this study. Their primary tumor site was not detected by routine computed tomography, magnetic resonance imaging and laryngoscopy. The nasopharyngolarynx was examined by NBI endoscopy to explore the primary tumor site.

RESULTSA total of 53 cases with cervical lymph node metastasis of squamous cell carcinoma from an unknown primary were examined under NBI endoscopy. The primary tumor site was confirmed by NBI examination in 47.2% (25/53) of patients, significantly better than routine radiology and endoscopy (0, P < 0.001). These primary tumors were small and superficial, with characteristic mucosal vascular morphologies. The superficial nasopharyngeal carcinomas under NBI examination showed the superficial thin branch-like or torturous line microvessels. The notable characteristics of the squamous cell carcinoma of oropharynx, hypopharynx and larynx was the well demarcated brownish area and scattered brown dots.

CONCLUSIONThe NBI endoscopy can provide better visualization of the morphology of superficial mucosal vasculature and improve the ability to detect possible primary cancer in patients with primary unknown cervical lymph node metastasis.

Adult ; Aged ; Aged, 80 and over ; Carcinoma ; Carcinoma in Situ ; diagnosis ; therapy ; Carcinoma, Squamous Cell ; diagnosis ; secondary ; therapy ; Female ; Follow-Up Studies ; Humans ; Hypopharyngeal Neoplasms ; diagnosis ; therapy ; Laryngeal Neoplasms ; diagnosis ; therapy ; Lymphatic Metastasis ; Male ; Middle Aged ; Narrow Band Imaging ; methods ; Nasopharyngeal Neoplasms ; diagnosis ; therapy ; Neoplasms, Unknown Primary ; diagnosis ; therapy ; Oropharyngeal Neoplasms ; diagnosis ; therapy

OBJECTIVE: To study the clinicopathological characteristics, diagnosis and differential diagnosis of hypopharyngeal carcinosarcoma. METHOD: Clinical data of one case with hypopharyngeal carcinosarcoma proved by pathology were analyzed retrospectively. The related literatures were reviewed. RESULT: The masses were surgically removed,and the postoperative diagnosis was confirmed to be carcinosarcoma by histopathological examination. After radiotherapy and chemotherapy, the patient recovered well postoperatively without recurrence during 18-month follow-up. CONCLUSION Carcinosarcoma of the hypopharynx is an extremely rare malignant tumor with distinctive histological, clinical and immunohistochemical features. The final diagnosis depends on histopathology. This tumor should be differentiated from other tumors such as sarcomatoid carcinoma and the reaction of radiotherapy of carcinoma. Surgery is the proper treatment strategy for carcinosarcoma of the hypopharynx. The patients with locally advanced, postoperative residual tumor or tumor without clear safe surgical margin should undergo radiotherapy, and the postoperative follow up should be in time.
Carcinoma, Squamous Cell ; diagnosis ; pathology ; Carcinosarcoma ; diagnosis ; pathology ; Humans ; Hypopharyngeal Neoplasms ; diagnosis ; pathology ; Hypopharynx ; pathology ; Male ; Middle Aged ; Rhabdomyosarcoma ; diagnosis ; pathology