Carcinoma Arising in a Pharyngeal Pouch Previously Treated by Endoscopic Stapling

Abstract

This is the first reported case of a carcinoma developing in a recurrent pharyngeal diverticulum previously treated by endoscopic stapling and brings to light a rare risk of endoscopic stapling procedures for the treatment of pharyngeal diverticula.

Systematic review of carcinoma arising in pharyngeal diverticula: A 112-year analysis

“…The remaining 52% of cases ( n = 30 of 58) were discovered retrospectively after histological analysis of an excised “benign” diverticulum. This result is of concern given that there is an increasing trend toward endoscopic stapling of pharyngeal diverticula, there exists a real danger that a malignancy may be missed, with one such case having been reported recently . Surgeons using stapling techniques may want to consider the merits of following up with their patients for a longer period of time to ensure that a retained diverticulum does not become malignant.…”

Esophageal diverticula and cancer

“…Odd symptoms have been described and must alert to the possibility of malignancy, such as the presence of blood in the regurgitated material, regurgitation of peaces of the tumor, odynophagia, and hemathemesis 10,11,21,32–35 …”

“…The main risk factors for the development of malignancy are frequently quoted as old age of the patient, the duration over which the pouch has been present, and its size 34 . In the 49 squamous cell carcinoma cases we collected (Table 1) the mean age of the patients was 69 years.…”

“…Several cases of carcinoma in previously treated diverticula have been reported, especially after endoscopic treatment 7,20,27,34,47 . Very interestingly, however, a carcinoma may develop in treated diverticula, even after resection 7,20,23,27,34,47,48 …”

“…Odd symptoms have been described and must alert to the possibility of malignancy, such as the presence of blood in the regurgitated material, regurgitation of peaces of the tumor, odynophagia, and hemathemesis. 10,11,21,[32][33][34][35] The main risk factors for the development of malignancy are frequently quoted as old age of the patient, the duration over which the pouch has been present, and its size. 34 In the 49 squamous cell carcinoma cases we collected ( Table 1) the mean age of the patients was 69 years.…”