Cervical node metastasis in Carcinoma of Pyriform Sinus: A prospective analysis of prevalence and distribution

The present study included 28 cases of carcinoma of pyriform sinus admitted in ENT ward of SMS Hospital in year 2000. The present work has been undertaken to analyse the prevalence and distribution of cervical lymph node metastases in cases of Pyriform sinus carcinoma, to compare the incidence and distribution of lymph node metastasis in medial vs lateral wall pyriform sinus carcinoma and to review the case of pyriform sinus carcinoma in reference to symptoms, clinical features and histopathological tumor staging.Most of the patients were in 6(th) decade of life. Sex incidence observed was male 93% and female 7% Histological variety was moderately differentiated squamous cell carcinoma (46.5%) which differs from the previous studies reporting the commonest variety to be poorly differentiated squamous cell carcinoma.It was observed in this series that 60% cases were of malignancy medial wall of pyriform fossa and 40% cases were of both lateral and medial wall. In contrast to previous studies which suggested that chances of contralateral cervical metastases was more with carcinoma involving medial wall of pyriform sinus, we observed equal incidence of contralateral node metastases in both group of pyriform sinus carcinoma case.In the present study 75% cases presented to us with T(4) stage. Though there were 4 cases of T(1) tumor in present series but none were in TNM stage I or II. This indicates that there is essentially no difference in the risk of lymph node metastases by T-stage.