Carcinoma arising from pharyngeal diverticula.

Area of Science:

• Otolaryngology
• Surgical Oncology
• Gastroenterology

Background:

• Pharyngeal diverticulum carcinoma (Zenker's diverticulum cancer) is a rare malignancy with a historically poor prognosis.
• Malignancy in a recurrent pharyngeal diverticulum is exceptionally rare, with limited documented cases.

Observation:

• The study presents two unique cases of pharyngeal diverticulum carcinoma.
• One patient had carcinoma in a recurrent diverticulum excised 20 years prior.
• The other patient presented with a neck mass as the sole indicator of pharyngeal diverticulum carcinoma.

Findings:

• Both patients underwent open resection with laryngeal preservation and postoperative radiotherapy (PORT).
• This treatment strategy resulted in long-term tumor control and disease-free survival, reaching 5 and 15 years.
• The patients maintained normal speech and swallowing functions post-treatment.

Implications:

• One-stage diverticulectomy, with or without radiotherapy, is identified as the preferred treatment for pharyngeal diverticulum carcinoma.
• This approach can achieve durable long-term control and survival for patients diagnosed with Zenker's diverticulum cancer.
• The findings suggest that aggressive surgical management combined with adjuvant therapy can lead to favorable outcomes even in rare recurrent cases.