Head and neck cancer in transplant recipients

Transplant recipients have an increased incidence of cancer compared with the general population. Head and neck sites are involved in more than 50% of patients, and as a result the otolaryngologist should be familiar with the diagnosis and management of posttransplant malignancies.

Skin cancer is the most common malignancy encountered in the transplant population, and in areas of high sun exposure, as many as 80% of patients are affected. Patients who undergo liver transplantation for alcoholic cirrhosis appear to be at particularly increased risk for developing posttransplant malignancy of the head and neck. A number of uncommon malignancies such as Kaposi's sarcoma occur with a greatly increased incidence in transplant recipients. Malignancy in this patient population tends to present at a younger age compared with the general population, with a more aggressive course and poorer outcomes reported.

A high index of suspicion may reduce morbidity and mortality through early detection of malignant disease in the transplant recipient.