title: A case of fatal respiratory failure after surgery for advanced supraglottic laryngeal carcinoma.
abstract: Pulmonary lymphangitic carcinomatosis (PLC) is an uncommon type of pulmonary metastasis from laryngeal carcinoma. We encountered a case of fatal respiratory failure after surgery for supraglottic laryngeal carcinoma with multiple cervical lymph node metastases. On day 25 postoperatively, the patient suddenly developed fever and noted slowly progressive difficulty in breathing. Laboratory data, radiological findings, and the clinical course of this patient were strongly suggestive of PLC. The patient refused fiberoptic bronchoscopy and glucocorticoid therapy, leading to rapid deterioration due to increasing respiratory distress, and died of respiratory failure on postoperative day 32. PLC should be considered a possible presentation of pulmonary metastasis associated with head and neck carcinoma. Chest CT may be needed to detect subclinical PLC, especially in cases of advanced head and neck carcinomas.
authors.affiliation: Department of Otolaryngology and Head & Neck Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. h-iguchi@med.osaka-cu.ac.jp
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Iguchi
authors.forename: Kazuya
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Kishiko
authors.initials: K
authors.lastname: Sunami
authors.forename: Hideo
authors.initials: H
authors.lastname: Yamane
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000556:secondary*; D017809:Fatal Outcome; D005931:Glottis / Q000601:surgery; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D008175:Lung Neoplasms / Q000150:complications / Q000556:secondary*; D008207:Lymphatic Metastasis; D008297:Male; D037981:Neck Dissection; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure