Recurrence due to neoplastic seeding in head and neck cancer: report of two cases and review of the literature

Tumori. 2013 Jul-Aug;99(4):e144-7. doi: 10.1177/030089161309900421.

Abstract

Aims and background: Tumor progression due to seeding of tumor cells after definitive treatment for squamous cell carcinomas of the head and neck is an uncommon condition that can considerably worsen the outcome of patients with head and neck cancer.

Methods and study design: We report two cases of recurrence due to neoplastic seeding from oropharyngeal and oral cancer, respectively. We performed a literature review with MEDLINE as the main search engine.

Results: Seeding was found to occur most often in tracheotomy scars and gastrostomy sites. The oral cavity, hypopharynx and oropharynx were the primary sites in most cases, and advanced tumor stage seemed to be a risk factor for seeding. Treatment options include salvage surgery, which requires thorough resections, radiotherapy when possible, and palliative management. The prognosis of such events is poor.

Conclusion: Although neoplastic seeding is a well-known phenomenon in cancer surgery, many questions remain unanswered, especially regarding preventive measures and management strategies.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Carcinoma, Squamous Cell / diagnosis*
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / surgery
  • Carcinoma, Squamous Cell / therapy*
  • Fatal Outcome
  • Head and Neck Neoplasms / diagnosis*
  • Head and Neck Neoplasms / radiotherapy
  • Head and Neck Neoplasms / surgery
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Mouth Neoplasms / therapy
  • Neck Dissection
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Seeding*
  • Neoplasm Staging
  • Palliative Care
  • Reoperation
  • Retreatment
  • Salvage Therapy / methods
  • Tonsillar Neoplasms / therapy
  • Tracheotomy*
  • Treatment Outcome