Head and neck mucoepidermoid carcinoma: a curious association with second primary malignancy

We noticed that a significant proportion of our patients with head and neck mucoepidermoid carcinoma (HNMEC) had second primary malignancies. To our knowledge, such an association has never been described. The aim of our study is to elucidate the association between second primary malignancies and HNMEC.

Case series with chart review.

Tertiary referral center.

We included all patients with histologically proven HNMEC managed in the Department of Surgery, Queen Mary Hospital, from January 2003 through December 2013. Medical records were retrospectively reviewed and analyzed.

Fifty-seven patients with HNMEC were identified. Fourteen (24.6%) had second primary malignancies. The commonest second primary malignancy was nasopharyngeal carcinoma, followed by carcinoma of the thyroid. Second primary malignancies developed before HNMEC in 7 patients, with a mean interval of 196 months. Five patients had second primary malignancies after development of HNMEC, with a mean interval of 65 months. Two patients had synchronous second primary malignancies. Clinical patterns of patients with HNMEC with and without second primary malignancies were compared. Major salivary glands were more frequently affected among patients with second primary malignancies, while minor salivary glands were more frequently affected among those without secondary primary malignancies (P = .032). Development of second primary malignancy was not found to affect the survival.

About one-fourth of patients with HNMEC had a second primary malignancy. Major salivary glands were more frequently affected among patients with second primary malignancies. Development of second primary malignancy did not affect survival.