The biphasic pattern of laryngeal and hypopharyngeal adenosquamous carcinoma is retained in lymph node metastases.

摘要

Sir: We read with great interest the paper of Alos et al. on head and neck adenosquamous carcinomas and utterly agree with the opinions expressed in it about the diagnostic criteria of this rare and controversial neoplasm.We would, however, like to highlight two issues based upon our own experience with four cases diagnosed in our laboratory in a 21-year period (1982-2002), that is, the overt tendency to develop loco-regional lymph node metastases, and its peculiar biphasic pattern of growth.2Our patients were all males between 54 and 71 years old (average 66 years) who developed typical adenosquamous carcinomas in the larynx (three cases) and right piriform sinus (one case, E-III, pT3/pNl)). Laryngeal tumours were transglottic in two cases (E-IVa, pT4/pN2 and E-III, pT3/pNl) and supraglottic in one (E-IVa, pT3/pN2). Treatment in all cases included radical surgery, chemotherapy and radiotherapy. Three patients died of tumour 22, 32 and 58 months after the diagnosis (average 37. months), two of them with previous tumour recurrences. The fourth case was lost for follow-up. Prior to surgery, all the cases had small endoscopic biopsies diagnosed as squamous cell carcinomas.