Bronchopulmonary changes after laryngeal cancer treatment--differentiation between metastatic laryngeal and second primary cancer.

The survivors of laryngeal cancer have an increased risk of second primary cancer, especially in the lung. Therefore, the authors were interested, if there is an increase of precancerous lesions or malignancies in bronchopulmonary biopsies of the patients after laryngeal cancer treatment. There were 70 (38 transbronchial and 32 bronchial) of 5,097 bronchopulmonary biopsies in 58 patients (55 men and 3 women) with history of laryngeal carcinoma. The age of the patients ranged from 39 to 81 years (mean value 62.5 years). The biopsies were performed from 1 month to 23 years after surgical treatment and/or radiation therapy due to squamous laryngeal carcinoma. The frequency of metaplastic, dysplastic and tumorous lesions was contrary to expectation a bit lower than in routine bronchial biopsies. But in contrast with the latter, metastases were 10 times more common among tumorous lesions. In 19 of 58 patients malignancies appeared from 1 month up to 276 months after laryngectomy. Four patients had definitively, and another 5 very probably second primary carcinoma. Ten patients presented with metastases from laryngeal cancer. The possibilities to differentiate metastatic laryngeal and second primary carcinoma are discussed.