Pharyngeal pouch carcinoma.

Malignant change occurs in 0.3-10% of pharyngeal pouches, with longstanding pouches most at risk. Contrast radiology and endoscopy can detect large and medium sized tumors but are inadequate for small lesions and carcinoma in situ. Expectant treatment and conservative surgery fail to provide an excised pouch for histological analysis and small lesions may be missed. Consequently, careful consideration must be given to radical excision, particularly if the pouch has been longstanding. The role of radiotherapy in conjunction with surgery remains unproven.