Head and neck cancer developing in patients with pre-existing reticuloendothelial malignancies.

Second primary tumors develop in up to 20% of patients with reticuloendothelial malignancies (REM). At the M. D. Anderson Hospital between 1944 and 1975, there were 29 patients with pre-existing reticuloendothelial malignancies who developed second primary tumors of the head and neck. The presence of pre-existing REM complicated staging of the head and neck lesion in 14 of 29 cases (48%). In patients with clinically palpable nodes the status of involvement was correctly assessed in only 4 of 14 instances (28%). Though only 3 of 29 patients (10%) survived for 5 or more years, the average survival from diagnosis of head and neck cancer to last follow-up or death was 31 months. Patients with REM in conjunction with head and neck melanoma or with squamous carcinoma of the facial skin or lip had an average survival of 20.7, 40.3, and 51.3 months respectively. Patients with REM in conjunction with second primaries involving the oral cavity, nasal, or oral pharynx, hypopharynx, or larynx did poorly with an average survival of only 8.5 months.