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?
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5 comments:
Is it a pharyngocutaneous fistula?
Pharyngocutaneous fistula
Predisposing factors: poor nutritional status, previous radiation, positive surgical margins, concurrent medical disease
i think its a recurrance of laryngeal cancer
predisposing factors: previous radiation, fistula formation
treatment options: neck dissection
Thank you for your answers.
This 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.
Sorry My. Yap, I hope you don't mind me commenting, this is good fun.
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