Untitled

Abstract

A case of hypopharyngeal carcinoma associated with mycosis fungoides is reported. The patient, 71 year-old male, had suffered from mycosis fungoides for 12 years, and was treated with steroids, cyclophosphamides, and photochemotherapy (oral methoxsalen and longwave ultraviolet light).Since difficulty of swallowing began in March, 1978, and becoming worse, he visited our clinic in May, 1978. At that time, he was at infilurative stage (second stage) of mycosis fungoides. Fluoroscopy showed a space occupying lesion in the right piriform sinus, and biopsy confirmed a squamous cell carcinoma of hypopharynx. The hypopharyngeal lesion was irradiated (Linac 170 rads per day, total dose of 5950 rads), and pharyngectomy and right neck dissection were done in August, 1978. Reconstruction of the hypopharynx using laryngeal autograft was performed at the same time. Postoperative course was fairly well, and the patient was discharged one month after the operation.In January, 1979, mycosis fungoides exacerbated again, and refractory to ordinary medical treatments. This time, he was treated with electron beam irradiation, and consequently mycosis fungoides was well controlled. But in April, 1979, he complained of disphagia again, and recurrence of hypopharyngeal carcinoma in the laryngeal autograft was found. The recurrent lesion was treated with irradiation and bleomycin. He died of renal dysfunction and bronchopneumonia in July, 1979. Necropsy revealed metastases in the right parotid and right lung and no evidence of visceral involvement of mycosis fungoides. Renal failure was due to marked arteriosclerosis.