Recurrent Squamous Cell Carcinoma in the Neopharynx Treated Successfully With Topical 5-Fluorouracil
6/12/2005 Oxford, England Rupan Banga et al. Red Nova (rednova.com) Abstract We present the first reported case of a squamous cell carcinoma recurrence on a reconstructed flap in the pharynx treated successfully with topical chemotherapy. The patient, treated for a pharyngeal cancer with resection and reconstruction with a free radial forearm flap, and post-operative radiotherapy, developed a tumour on the flap more than two years after surgery. The recurrence was also squamous carcinoma, but there was only superficial infiltration. This was treated with 5-fluorouracil paste placed in the pharynx, with resolution of the tumour. The patient was alive and well more than 28 months after this treatment, with no sign of disease recurrence. Topical chemotherapy for treatment of oral cancer is well described for early disease, but we show that it may be a useful treatment in recurrent disease in selected patients. Case history A 76-year-old male ex-smoker was referred to the Oxford Head and Neck Centre with a T^sub 4^ N^sub 1^ post-cricoid carcinoma. He had been treated 22 years previously with primary external beam radiotherapy for a tongue-base squamous cell carcinoma. The post- cricoid tumour presented within the field of the previous external beam radiotherapy. This tumour was treated with intent to cure in February 2000 with a total laryngectomy, partial pharyngectomy, left hemi- thyroidectomy, left radical neck dissection and a right selective neck dissection. The pharyngeal defect was reconstructed with a left radial forearm free flap. A salivary fistula through the posterior wall of the trachea complicated [...]