Carcinoma of Pharynx and Oesophagus
Object numberGC.14274
TitleCarcinoma of Pharynx and Oesophagus
DescriptionPost cricoid squamous cell carcinoma
From a female aged 51 years.
First Admitted 23.9.63.
Difficulty in swallowing for two months -
Swelling in mid line of neck for two weeks.
Thyreoidectomy 30 years ago.
On examination — An abscess 4” in diameter was present in the mid line of the neck anteriorly at the site of the thyreoidectomy scar. No lymph nodes palpable.
On indirect laryngoscopy, slough was seen in the post cricoid region.
24.9.63 Oesophagoscopy — Carcinoma involving L. piriform fossa, and post cricoid region. Strip of normal mucosa in R. piriform fossa, but oesophagoscope could not be passed through.
Biopsy — Actively growing well—differentiated squamous carcinoma.
Abscess aspirated daily until it had almost completely resolved.
Radiotherapy commenced 9.10. 63,.
8.11.63. Radiotherapy completed. During past two days abscess recurred and now contained air, showing that it was due to a leak from the hypo-pharynx. With repeated aspiration abscess resolved with suprasternal induration only.
28.11.63. Oesophagoscopy. Small granular area in post cricoid region. No other abnormality apart from some narrowing. Biopsy negative.
28.1.64.. Swallowing well — normal diet.
25.2.64. Complains of pain in throat, referred to both ears. Unable to eat solid food.
On examination. No nodes palpable in neck. Supra sternal induration.
On indirect laryngoscopy, slough was seen in post cricoid region.
27.2.64. Oesophagoscopy. Recurrence of- carcinoma encircling post cricoid region. Oesophagoscope could not be passed through to define downward extent. Biopsy — Moderately differentiated squamous cell carcinoma.
Barium swallow suggested that lower end of tumour was supra clavicular.
12.3.64. Pharyngo-laryngectomy — The tumour extended to just above the thoracic inlet. Oesophagus divided immediately below tumour. Posteriorly tumour was invading prevertebral fascia. This area of pre-vertebral fascia was excised.
Upper pharyngostome, oesophagostome and tracheostome fashioned using lateral skin flap.
Pathology reports:
Paratracheal lymph nodes.
Inflammatory cell infiltration but no tumour seen.
Prevertebral fascia.
Invasion by moderately well differentiated squamous call carcinoma.
The specimen has been split in the midline posteriorly and the two halves opened out. This demonstrates that the oesophagus throughout the lendth of the specimen is the site of a carcinoma which extends up into the pharynx and involves the mucosa and the muscularis. In the lower part there is a papilliferous area projecting into the lumen. The larynx is not involved in the tumour.
Production placeRoyal Infirmary, Edinburgh
Production date Surgery 1964-03-12 - 1964
Production periodTwentieth century
Object namePHARYNX/OESOPHAGUS
Object categoryAnatomical, specimen
TechniquePharyngo-laryngectomy
Dimensions
- Jar Height: 13 cm
Width: 13 cm
Depth: 7.5 cm