Sistema Gastrointestinal e Digestivo

Abstrato

Endoscopic Submucosal Dissection of Secondary Hypopharyngeal Neoplasia in Trismus Oral Cancer Patients: Case Series Report

Chen-Shuan Chung, Wu-Chia Lo, Kuan-Chih Chen and Li-Jen Liao

The incidence of second primary tumor (SPT) in head and neck (H&N) cancer patients is not uncommon [1,2]. When using image-enhanced endoscopy (IEE) screening in patients at risk, especially narrow-band imaging (NBI) endoscopy and chromoendoscopy with Lugol's solution, approximately 20% of H&N cancer patients have synchronous neoplasia in H&N regions of esophagus [1,2]. Unfortunately, some of them have trismus because of oral submucosa fibrosis secondary to long-term betel quit chewing or post-irradiation therapy, and tumor-related airway compromised. These situations make the pharyngeal passages difficult to reach with conventional endoscopes. Traditionally, hypopharyngeal neoplasia in trismus patients are managed with widest field of resection, open partial pharyngectomy and usually in conjunction with partial or total laryngectomy, which are accompanied with poor quality of life (QoL). We present three trismus patients with early hypopharyngeal neoplasia treated by transoral endoscopic submucosal dissection (ESD).