Axillary metastases from carcinoma of the larynx: a 25-year survival

Axillary metastases from squamous cell carcinomas of the head and neck are usually considered signs of incurability. A case is presented in which the patient developed well-differentiated squamous cell carcinoma in bilateral axillary nodes following total laryngectomy and radical neck dissection for advanced recurrent squamous cell carcinoma of the larynx. Bilateral axillary dissection was performed on this patient followed by a second neck dissection for metastasis. The patient remained well for 25 years free of disease, dying of a massive heart attack. One report of this phenomenon has been found in the literature. The authors conclude that radical axillary dissection should be considered in selective cases of well-differentiated carcinoma in axillary nodes from a controlled primary in the head and neck mucosa when no other signs of dissemination have been found. A brief review of cervical and axillary lymphatic anatomy is included.