This 60yr old gentleman had his larynx removed for laryngeal cancer. 6 months later, this swelling has appeared in close proximity to the tracheal stoma.
What is this condition known as?
What predisposes to this occurence?
What are treatment options for him?
Is it a pharyngocutaneous fistula?
ReplyDeletePharyngocutaneous fistula
ReplyDeletePredisposing factors: poor nutritional status, previous radiation, positive surgical margins, concurrent medical disease
i think its a recurrance of laryngeal cancer
ReplyDeletepredisposing factors: previous radiation, fistula formation
treatment options: neck dissection
Thank you for your answers.
ReplyDeleteThis is a STOMAL RECURRENCE - a recurrence of laryngeal cancer at and around the site of the tracheal-stoma.
Treatment options are surgical resection with reconstruction or radiotherapy.
One pre-disposing factor is inadequate margin of surgical excision during initial total laryngectomy. Some people claim that prior tracheostomy is another pre-disposing factor but there is low Level 3 evidence in the literature to suggest that emergency laryngectomy is not better than emergency tracheostomy and semi-elective surgery later on. Stomal recurrence is a bad news, people try to assess resectability by its lower extension into the stoma but sensible doctor should look for palliative treatment.
ReplyDeleteSorry My. Yap, I hope you don't mind me commenting, this is good fun.