Clinical review of autopsy cases that succumbed to head and neck malignancies

We investigated autopsy cases that had succumbed to head and neck malignancies in the light of the relationships between locoregional tumors and distant metastasis, between the frequency and site of distant metastasis and between the occurrence of locoregional tumors/distant metastasis and the cause of death. Of the 203 cases autopsied at the Kitasato University Hospital between 1972 and 1999, 174 had epithelial tumors and 29 had non-epithelial tumors (malignant lymphoma in 20/29). In terms of epithelial tumors, 107 patients (61%) had locoregional disease and 101 (58%) exhibited distant metastases; 39 cases (28%) had distant metastasis without locoregional tumors. Although the cause of death was mostly as the result of locoregional disease, death related to distant metastasis was also frequently observed. Of the 20 cases with malignant lymphoma, 17 had distant metastases and only 2 of them manifested tumors in the primary region. All 17 patients with distant metastases showed tumors in the distant lymph nodes, with a relatively high occurrence of metastasis to the gastrointestinal tract. Key words: cause of death, distant metastasis, locoregional tumor.