Title:Head and Neck Cancer with Lung Metastases: Treatment Challenges
Volume: 6
Author(s): Selvamalar Vengathajalam*Norhafiza Mat Lazim
Affiliation:
- Department of Otorhinolaryngology - Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Health Campus Kubang Kerian 16150, Kelantan,Malaysia
Keywords:
Head and neck cancer, Distant metastasis, oligometastasis, laryngeal carcinoma, mucoepidermoid carcinoma, papillary
thyroid carcinoma.
Abstract:
Background: Head and neck cancer has predilection of metastasising to the lung, bones or
liver. The site of metastasis usually depends on the primary tumour location, the staging and the regional
spread of the tumour. Patients with distant metastasis are predicted to have a poor prognosis
with low survival rate. Oligometastasis is the term used for an intermediate biologic state of restricted
metastatic capacity with limited number and sites of organ with metastasis. It is also defined by 5 or
less than 5 metastatic lesion in a disease with a controlled primary tumour.
Case reports: In this case series, we have reported three cases of head and neck carcinomas that pose
treatment dilemmas because of lung metastases. First case is a gentleman with laryngeal carcinoma
with multiple small lung metastases where the treatment options of surgery versus chemoradiation
was debated. The second case is a gentleman with low grade mucoepidermoid carcinoma of the parotid
gland with suspicious lung spread of disease. Lastly is a patient with papillary thyroid carcinoma
with florid lung metastases who completed chemoradiation.
Conclusion: The presence of lung metastases does not necessarily mean that the prospect of surviving
is poor for the patient. It is necessary to determine the best choice of treatment yielding the best quality
of life to maximize the survival period for these patients.
