Neoplastic lymphangiosis of the upper aerodigestive tract simulating field cancerization: histopathological analysis, surgical limits and literature review.
Neoplastic lymphangiosis is defined as extensive embolic spread of cancer cells in the lymphatic vessels often without any evidence of a mass. Instead, field cancerization is defined by the presence of multifocal neoplastic lesions in a mucosal field previously exposed to mutagenic factors. In this case report, this oncological entity was suggested by the wide extent and multifocality of the disease and by the patient's exposure to risk factors. Instead, the pathological slides revealed the integrity of the mucosa and the presence of widespread embolic metastasis to lymphatic vessels. Thus, the diagnosis was changed to neoplastic lymphangiosis. This clinical presentation is a negative prognostic factor, and surgical treatment is ineffective because of the impossibility to obtain adequate free margins. The present case underlines the poor prognosis of such locally advanced cancer and the importance of recognizing it early so that the treatment approach can be adapted.
Otolaryngology Unit, IRCCS Istituto Nazionale dei Tumori, Milan, Italy. franco.mattavelli@yahoo.it
Franco
F
Mattavelli
Natalia
N
Pizzi
Elisabetta
E
Pennacchioli
Stefano
S
Radaelli
Pasquale
P
Quattrone
Davide
D
Mattavelli
Andrea
A
Fior
Silvana
S
Pilotti
D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy* / Q000556:secondary*; D004938:Esophageal Neoplasms / Q000556:secondary; D017809:Fatal Outcome; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000532:radiotherapy*; D006801:Humans; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010610:Pharyngeal Neoplasms / Q000556:secondary; D011379:Prognosis; D012907:Smoking / Q000009:adverse effects*