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Hypopharyngeal Cancer

Determining the Type of Hypopharyngeal Cancer

Only after a pathologist analyzes some cells or actual pieces of tissue from the lesion will your doctor be able to tell you if you have cancer. Your doctor and pathologist should specialize in head and neck cancers because some benign (non-cancerous) lesions can look like cancer on a small biopsy.

  • Squamous cell carcinoma: These are by far the most common hypopharyngeal cancers (95 percent). They arise from cells lining the hypopharynx.
  • Squamous cell cancers of the hypopharynx are typically given a grade by a pathologist after looking at the cells under a microscope. Grade means that the tumor falls on a scale from well differentiated (Grade I) to poorly differentiated (Grade IV). It is generally felt that the prognosis for a more well-differentiated cancer is more favorable.

More rarely, other cancers can be found in the hypopharynx as well. Some of them include:

  • Salivary gland cancers: There are minor salivary glands located under the lining of the throat. This is why cancers that we typically see in salivary glands can arise in this region. They include diagnoses such as mucoepidermoid carcinomas, adenocarcinomas and adenoid cystic carcinomas, to name a few. See Salivary Gland Cancer for more information.
  • Lymphoma: Lymphoma is cancer of the lymphatic system, which includes lymph nodes, lymph channels, lymphatic fluid and lymphoid tissue. The throat is lined with lymphoid cells. Some major sites of lymphoid tissue include the adenoids in the nasopharynx and palatine tonsils and lingual tonsils in the oropharynx. This is why lymphoma might appear as a lump in the throat area.
  • Mucosal melanoma: These cancers come from skin cells that give skin its color. In rare cases, melanoma can be found in the lining of the mouth, nose and/or throat.

Other extremely rare cancers of the hypopharynx include:

  • Sarcomas such as chondsarcoma, liposarcoma and synovial sarcoma
  • Malignant fibrous histiocytoma
  • Peripheral Neuroectodermal Tumor (PNET)
  • Cancer spread from another site
References

1 Harrison DF. Pathology of hypopharyngeal cancer in relation to surgical management. The Journal of laryngology and otology. Apr 1970;84(4):349-367.

2 Shah JP, Shaha AR, Spiro RH, Strong EW. Carcinoma of the hypopharynx. Am J Surg. Oct 1976;132(4):439-443.

3 Menvielle G, Luce D, Goldberg P, Leclerc A. Smoking, alcohol drinking, occupational exposures and social inequalities in hypopharyngeal and laryngeal cancer. International journal of epidemiology. Aug 2004;33(4):799-806.

4 Larsson LG, Sandstrom A, Westling P. Relationship of Plummer-Vinson disease to cancer of the upper alimentary tract in Sweden. Cancer research. Nov 1975;35(11 Pt. 2):3308-3316.

5 Marchand JL, Luce D, Leclerc A, et al. Laryngeal and hypopharyngeal cancer and occupational exposure to asbestos and man-made vitreous fibers: results of a case-control study. Am J Ind Med. Jun 2000;37(6):581-589.

6 Dolan RW, Vaughan CW, Fuleihan N. Symptoms in early head and neck cancer: an inadequate indicator. Otolaryngology--head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery. Nov 1998;119(5):463-467.

7 Spiro RH, Thaler HT, Hicks WF, Kher UA, Huvos AH, Strong EW. The importance of clinical staging of minor salivary gland carcinoma. Am J Surg. 1991 Oct;162(4):330-6.

8 Krause CJ, Carey TE, Ott RW, Hurbis C, McClatchey KD, Regezi JA. Human squamous cell carcinoma. Establishment and characterization of new permanent cell lines. Arch Otolaryngol. Nov 1981;107(11):703-710.

9 Piccirillo JF, Costas I, Reichman ME. Chapter 2: Cancers of the Head and Neck. Ries LAG, Young JL, Keel GE, Eisner MP, Lin YD, Horner M-J (editors). SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. National Cancer Institute, SEER Program, NIH Pub. No. 07-6215, Bethesda, MD, 2007.

10 Amin M, Edge S, Greene F, et al. AJCC Cancer Staging Manual, 8th ed. New York: Springer; 2017.

11 Lefebvre JL, Rolland F, Tesselaar M, et al. Phase 3 randomized trial on larynx preservation comparing sequential vs alternating chemotherapy and radiotherapy. J Natl Cancer Inst. 2009;101(3):142-52.

12 Henriques de figueiredo B, Fortpied C, Menis J, et al. Long-term update of the 24954 EORTC phase III trial on larynx preservation. Eur J Cancer. 2016;65:109-12.

13 Cohen, E. E., LaMonte, S. J., Erb, N. L., Beckman, K. L., Sadeghi, N. , Hutcheson, K. A., Stubblefield, M. D., Abbott, D. M., Fisher, P. S., Stein, K. D., Lyman, G. H. and Pratt‐Chapman, M. L. (2016), American Cancer Society Head and Neck Cancer Survivorship Care Guideline. CA: A Cancer Journal for Clinicians, 66: 203-239. doi:10.3322/caac.21343

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