HYPOPHARYNGEAL CARCINOMA WITH CLINICAL PERITONEAL CARCINOMATOSIS - A REPORT OF 2 PATIENTS

Most patients with hypopharyngeal carcinomas show advanced disease, ei ther at the primary site or in the neck, at the time of diagnosis. Des pite intensive therapy, a great number of recurrences and distant meta stases can be observed. The most common metastatic sites are the lung and bane, and only in autopsy cases has peritoneum carcinomatosis been mentioned as a metastatic site. Since January 1992, two of 78 patient s (2.3%) with advanced hypopharyngeal squamous cell carcinomas (SCCs) treated initially by chemotherapy in our department developed clinical peritoneal carcinomatosis during their natural courses. Both patients were man patients with advanced locoregional disease at stage T4N3. T heir clinical peritoneal carcinomatosis appeared during chemotherapy, with good disease control above the clavicle. Both patients eventually died of sepsis within 1 month after diagnosis of the peritoneal carci nomatosis. The authors suggest that peritoneal carcinomatosis is not a s rare as previously believed, and should be included in the different ial diagnosis in patients with advanced hypopharyngeal SCC with abdomi nal symptoms. Peritoneal carcinomatosis appears to be refractory to ch emotherapy, and carried a poor prognosis in patients in the present st udy.