Multiple primary carcinomas of the head, neck, and lung

The case histories of 8,956 patients treated for primary malignancies arising in the lung, head and neck, or both were reviewed. Eighty-five (21%) of 406 patients with primary bronchogenic malignancy associated with neoplasms at other sites had head and neck malignancies; they comprise 0.9% of the total and form the basis of this report. The head and neck malignancy preceded bronchogenic carcinoma in 70 patients; bronchogenic carcinoma occurred first in 8 patients; and malignancies occurred in both sites synchronously in 7 patients. Case histories and tabular analysis of pathology, social history, time interval between lesions, treatment, and survival are presented. A strong association between heavy cigarette smoking, alcoholism, and multicentric respiratory tract malignancies is noted. Critical analysis supports aggressive treatment of each lesion as a separate solitary primary malignancy.