Prof. Miquel Quer (Barcelona)
69 years old
Job: Historian. Retired.
Third H&N carcinoma in a former smoker and social drinker. 10 years ago he was treated with concomitant chemo-radiotherapy for a T3N2bM0 (Stage IVa) of a tumor in the left piriform sinus with fixation of the left vocal fold.
3 years ago he was treated with transoral surgery (base of tongue resection plus suprahyoid epiglottis resection) + bilateral neck dissection for a T2N0M0 squamous cell carcinoma of the vallecula.
In June 2018 a new squamous cell carcinoma was detected, this time in the right piriform sinus, superficial and affecting also the posterior wall (T2N0M0). A transoral laser resection was performed in July, but a recurrence was detected recently.
Diagnosis: Squamous cell carcinoma of the right hypopharynx (T2N0M0) in a setting of third H&N cancer previously irradiated and operated.
Treatment proposed: Total laryngopharyngectomy (circular) + neck dissection + reconstruction with pectoralis major flap (due to periferical arteriopaty a microvascular reconstruction is not advised)