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Article
March 1986

Multiple Malignancies of the Lung and Head and NeckSecond Primary Tumor or Metastasis?

Author Affiliations

From the Departments of Surgery (Division of Cardiopulmonary Surgery) (Drs Lefor and Bredenberg) and Otolaryngology (Dr Kellman), State University of New York (SUNY) Upstate Medical Center, Syracuse, and Syracuse Veterans Administration Medical Center (Dr Aust).

Arch Surg. 1986;121(3):265-270. doi:10.1001/archsurg.1986.01400030019001
Abstract

• Independent primary cancers of the head and neck and of the lung may be confused with lung metastases from a head and neck tumor. We retrospectively reviewed the cases of 55 patients who had head and neck malignancies and pulmonary lesions. To distinguish between independent primary tumors and lung metastases we applied an algorithm using the following criteria: (1) sequence of appearance of the lesions; (2) tumor histology; (3) radiologic appearance of the lesions; and (4) presence of malignant anterior cervical adenopathy. In this group of 55 patients, 40 were categorized as having independent primary malignancies and 15 were categorized as having pulmonary metastases from the head and neck tumor. In cases in which the origin of the pulmonary lesion is unclear, the patient should be treated as though independent primary malignancies were present since this offers the best chance for cure.

(Arch Surg 1986;121:265-270)

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