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Pyriform Sinus Squamous Cell Carcinoma
Patricia A. Hudgins, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Squamous cell carcinoma (SCCa)
            • Synonyms

              • Piriform sinus SCCa, pyriform fossa SCCa
            • Definitions

              • Mucosal malignancy of hypopharyngeal subsite
              • 2/3 of all hypopharyngeal SCCa arise in pyriform sinus

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              • Reporting Tips

                                                Selected References

                                                1. Tanzler ED et al: Challenging the need for random directed biopsies of the nasopharynx, pyriform sinus, and contralateral tonsil in the workup of unknown primary squamous cell carcinoma of the head and neck. Head Neck. 38(4):578-81, 2016
                                                2. Chung EJ et al: Pattern of cervical lymph node metastasis in medial wall pyriform sinus carcinoma. Laryngoscope. 124(4):882-7, 2014
                                                3. Yu Y et al: Neoadjuvant treatment combined with planned surgery in laryngeal function preservation for locally advanced pyriform sinus carcinoma. J Craniofac Surg. 25(6):1975-9, 2014
                                                4. Chen AY et al: Pitfalls in the staging squamous cell carcinoma of the hypopharynx. Neuroimaging Clin N Am. 23(1):67-79, 2013
                                                5. Blanchard P et al: Definitive radiotherapy for squamous cell carcinoma of the pyriform sinus. Radiother Oncol. 105(2):232-7, 2012
                                                6. Bonner JA et al: Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer: 5-year survival data from a phase 3 randomised trial, and relation between cetuximab-induced rash and survival. Lancet Oncol. 2010 Jan;11(1):21-8. Epub 2009 Nov 10. Erratum in: Lancet Oncol. 11(1):14, 2010
                                                7. Chu PY et al: Different patterns of second primary malignancy in patients with squamous cell carcinoma of larynx and hypopharynx. Am J Otolaryngol. 31(3):168-74, 2010
                                                8. Datema FR et al: Impact of comorbidity on short-term mortality and overall survival of head and neck cancer patients. Head Neck. 32(6):728-36, 2010
                                                9. Inohara H et al: Impact of FDG-PET on prediction of clinical outcome after concurrent chemoradiotherapy in hypopharyngeal carcinoma. Mol Imaging Biol. 12(1):89-97, 2010
                                                10. Joo YH et al: The impact of paratracheal lymph node metastasis in squamous cell carcinoma of the hypopharynx. Eur Arch Otorhinolaryngol. 267(6):945-50, 2010
                                                11. Kadota H et al: Comparison of salvage and planned pharyngolaryngectomy with jejunal transfer for hypopharyngeal carcinoma after chemoradiotherapy. Laryngoscope. 120(6):1103-8, 2010
                                                12. Karatzanis AD et al: T1 and T2 hypopharyngeal cancer treatment with laser microsurgery. J Surg Oncol. 102(1):27-33, 2010
                                                13. Leong SC et al: Early outcomes after transoral CO2 laser resection of laryngeal and hypopharyngeal squamous cell carcinoma: one centre's experience. J Laryngol Otol. 124(2):185-93, 2010
                                                14. Liu WS et al: Long-term results of intensity-modulated radiotherapy concomitant with chemotherapy for hypopharyngeal carcinoma aimed at laryngeal preservation. BMC Cancer. 10:102, 2010
                                                15. Park YM et al: Feasiblity of transoral robotic hypopharyngectomy for early-stage hypopharyngeal carcinoma. Oral Oncol. 46(8):597-602, 2010
                                                16. Tandon S et al: A systematic review of p53 as a prognostic factor of survival in squamous cell carcinoma of the four main anatomical subsites of the head and neck. Cancer Epidemiol Biomarkers Prev. 19(2):574-87, 2010
                                                17. Curado MP et al: Recent changes in the epidemiology of head and neck cancer. Curr Opin Oncol. 21(3):194-200, 2009
                                                18. Kogashiwa Y et al: Concurrent chemoradiotherapy for organ function preservation in advanced patients with hypopharyngeal and laryngeal cancer. Oncol Rep. 22(5):1163-7, 2009
                                                19. Mendenhall WM: Outcomes after surgery or definitive radiotherapy for hypopharyngeal cancer. Cancer. 115(24):5620-2, 2009
                                                20. Papacharalampous GX et al: Supracricoid hemilaryngopharyngectomy for selected pyriform sinus carcinoma patients--a retrospective chart review. World J Surg Oncol. 7:65, 2009
                                                21. Varghese BT et al: Treatment outcome in patients undergoing surgery for carcinoma larynx and hypopharynx: a follow-up study. Acta Otolaryngol. 129(12):1480-5, 2009
                                                22. Verduijn GM et al: Magnetic resonance imaging protocol optimization for delineation of gross tumor volume in hypopharyngeal and laryngeal tumors. Int J Radiat Oncol Biol Phys. 74(2):630-6, 2009
                                                23. Becker M et al: Imaging of the larynx and hypopharynx. Eur J Radiol. 66(3):460-79, 2008
                                                24. Becker M et al: Neoplastic invasion of laryngeal cartilage: reassessment of criteria for diagnosis at MR imaging. Radiology. 249(2):551-9, 2008
                                                25. Wycliffe ND et al: Hypopharyngeal cancer. Top Magn Reson Imaging. 18(4):243-58, 2007
                                                26. Hermans R: Staging of laryngeal and hypopharyngeal cancer: value of imaging studies. Eur Radiol. 16(11):2386-400, 2006
                                                27. Gleich LL et al: Recurrent advanced (T3 or T4) head and neck squamous cell carcinoma: is salvage possible? Arch Otolaryngol Head Neck Surg. 130(1):35-8, 2004
                                                28. Gourin CG et al: Carcinoma of the hypopharynx. Surg Oncol Clin N Am. 13(1):81-98, 2004
                                                29. Hanna E et al: Intensive chemoradiotherapy as a primary treatment for organ preservation in patients with advanced cancer of the head and neck: efficacy, toxic effects, and limitations. Arch Otolaryngol Head Neck Surg. 130(7):861-7, 2004
                                                30. Kutter J et al: Combined modality treatment with full-dose chemotherapy and concomitant boost radiotherapy for advanced head and neck carcinoma. Eur Arch Otorhinolaryngol. 261(6):400-6, 2004
                                                31. Agra IM et al: Postoperative complications after en bloc salvage surgery for head and neck cancer. Arch Otolaryngol Head Neck Surg. 129(12):1317-21, 2003
                                                32. Lore JM Jr et al: Carcinoma of the head and neck: a 5- to 20-year experience with preoperative chemotherapy, uncompromised surgery, and selective radiotherapy. Ann Surg Oncol. 10(6):645-53, 2003
                                                33. Schmalfuss IM: Imaging of the hypopharynx and cervical esophagus. Magn Reson Imaging Clin N Am. 10(3):495-509, vi, 2002
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          TERMINOLOGY

                                                          • Abbreviations

                                                            • Squamous cell carcinoma (SCCa)
                                                          • Synonyms

                                                            • Piriform sinus SCCa, pyriform fossa SCCa
                                                          • Definitions

                                                            • Mucosal malignancy of hypopharyngeal subsite
                                                            • 2/3 of all hypopharyngeal SCCa arise in pyriform sinus

                                                          IMAGING

                                                          • General Features

                                                            • Radiographic Findings

                                                              • CT Findings

                                                                • MR Findings

                                                                  • Nuclear Medicine Findings

                                                                    • Imaging Recommendations

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Staging, Grading, & Classification

                                                                            • Gross Pathologic & Surgical Features

                                                                              • Microscopic Features

                                                                                CLINICAL ISSUES

                                                                                • Presentation

                                                                                  • Demographics

                                                                                    • Natural History & Prognosis

                                                                                      • Treatment

                                                                                        DIAGNOSTIC CHECKLIST

                                                                                        • Consider

                                                                                          • Image Interpretation Pearls

                                                                                            • Reporting Tips

                                                                                              Selected References

                                                                                              1. Tanzler ED et al: Challenging the need for random directed biopsies of the nasopharynx, pyriform sinus, and contralateral tonsil in the workup of unknown primary squamous cell carcinoma of the head and neck. Head Neck. 38(4):578-81, 2016
                                                                                              2. Chung EJ et al: Pattern of cervical lymph node metastasis in medial wall pyriform sinus carcinoma. Laryngoscope. 124(4):882-7, 2014
                                                                                              3. Yu Y et al: Neoadjuvant treatment combined with planned surgery in laryngeal function preservation for locally advanced pyriform sinus carcinoma. J Craniofac Surg. 25(6):1975-9, 2014
                                                                                              4. Chen AY et al: Pitfalls in the staging squamous cell carcinoma of the hypopharynx. Neuroimaging Clin N Am. 23(1):67-79, 2013
                                                                                              5. Blanchard P et al: Definitive radiotherapy for squamous cell carcinoma of the pyriform sinus. Radiother Oncol. 105(2):232-7, 2012
                                                                                              6. Bonner JA et al: Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer: 5-year survival data from a phase 3 randomised trial, and relation between cetuximab-induced rash and survival. Lancet Oncol. 2010 Jan;11(1):21-8. Epub 2009 Nov 10. Erratum in: Lancet Oncol. 11(1):14, 2010
                                                                                              7. Chu PY et al: Different patterns of second primary malignancy in patients with squamous cell carcinoma of larynx and hypopharynx. Am J Otolaryngol. 31(3):168-74, 2010
                                                                                              8. Datema FR et al: Impact of comorbidity on short-term mortality and overall survival of head and neck cancer patients. Head Neck. 32(6):728-36, 2010
                                                                                              9. Inohara H et al: Impact of FDG-PET on prediction of clinical outcome after concurrent chemoradiotherapy in hypopharyngeal carcinoma. Mol Imaging Biol. 12(1):89-97, 2010
                                                                                              10. Joo YH et al: The impact of paratracheal lymph node metastasis in squamous cell carcinoma of the hypopharynx. Eur Arch Otorhinolaryngol. 267(6):945-50, 2010
                                                                                              11. Kadota H et al: Comparison of salvage and planned pharyngolaryngectomy with jejunal transfer for hypopharyngeal carcinoma after chemoradiotherapy. Laryngoscope. 120(6):1103-8, 2010
                                                                                              12. Karatzanis AD et al: T1 and T2 hypopharyngeal cancer treatment with laser microsurgery. J Surg Oncol. 102(1):27-33, 2010
                                                                                              13. Leong SC et al: Early outcomes after transoral CO2 laser resection of laryngeal and hypopharyngeal squamous cell carcinoma: one centre's experience. J Laryngol Otol. 124(2):185-93, 2010
                                                                                              14. Liu WS et al: Long-term results of intensity-modulated radiotherapy concomitant with chemotherapy for hypopharyngeal carcinoma aimed at laryngeal preservation. BMC Cancer. 10:102, 2010
                                                                                              15. Park YM et al: Feasiblity of transoral robotic hypopharyngectomy for early-stage hypopharyngeal carcinoma. Oral Oncol. 46(8):597-602, 2010
                                                                                              16. Tandon S et al: A systematic review of p53 as a prognostic factor of survival in squamous cell carcinoma of the four main anatomical subsites of the head and neck. Cancer Epidemiol Biomarkers Prev. 19(2):574-87, 2010
                                                                                              17. Curado MP et al: Recent changes in the epidemiology of head and neck cancer. Curr Opin Oncol. 21(3):194-200, 2009
                                                                                              18. Kogashiwa Y et al: Concurrent chemoradiotherapy for organ function preservation in advanced patients with hypopharyngeal and laryngeal cancer. Oncol Rep. 22(5):1163-7, 2009
                                                                                              19. Mendenhall WM: Outcomes after surgery or definitive radiotherapy for hypopharyngeal cancer. Cancer. 115(24):5620-2, 2009
                                                                                              20. Papacharalampous GX et al: Supracricoid hemilaryngopharyngectomy for selected pyriform sinus carcinoma patients--a retrospective chart review. World J Surg Oncol. 7:65, 2009
                                                                                              21. Varghese BT et al: Treatment outcome in patients undergoing surgery for carcinoma larynx and hypopharynx: a follow-up study. Acta Otolaryngol. 129(12):1480-5, 2009
                                                                                              22. Verduijn GM et al: Magnetic resonance imaging protocol optimization for delineation of gross tumor volume in hypopharyngeal and laryngeal tumors. Int J Radiat Oncol Biol Phys. 74(2):630-6, 2009
                                                                                              23. Becker M et al: Imaging of the larynx and hypopharynx. Eur J Radiol. 66(3):460-79, 2008
                                                                                              24. Becker M et al: Neoplastic invasion of laryngeal cartilage: reassessment of criteria for diagnosis at MR imaging. Radiology. 249(2):551-9, 2008
                                                                                              25. Wycliffe ND et al: Hypopharyngeal cancer. Top Magn Reson Imaging. 18(4):243-58, 2007
                                                                                              26. Hermans R: Staging of laryngeal and hypopharyngeal cancer: value of imaging studies. Eur Radiol. 16(11):2386-400, 2006
                                                                                              27. Gleich LL et al: Recurrent advanced (T3 or T4) head and neck squamous cell carcinoma: is salvage possible? Arch Otolaryngol Head Neck Surg. 130(1):35-8, 2004
                                                                                              28. Gourin CG et al: Carcinoma of the hypopharynx. Surg Oncol Clin N Am. 13(1):81-98, 2004
                                                                                              29. Hanna E et al: Intensive chemoradiotherapy as a primary treatment for organ preservation in patients with advanced cancer of the head and neck: efficacy, toxic effects, and limitations. Arch Otolaryngol Head Neck Surg. 130(7):861-7, 2004
                                                                                              30. Kutter J et al: Combined modality treatment with full-dose chemotherapy and concomitant boost radiotherapy for advanced head and neck carcinoma. Eur Arch Otorhinolaryngol. 261(6):400-6, 2004
                                                                                              31. Agra IM et al: Postoperative complications after en bloc salvage surgery for head and neck cancer. Arch Otolaryngol Head Neck Surg. 129(12):1317-21, 2003
                                                                                              32. Lore JM Jr et al: Carcinoma of the head and neck: a 5- to 20-year experience with preoperative chemotherapy, uncompromised surgery, and selective radiotherapy. Ann Surg Oncol. 10(6):645-53, 2003
                                                                                              33. Schmalfuss IM: Imaging of the hypopharynx and cervical esophagus. Magn Reson Imaging Clin N Am. 10(3):495-509, vi, 2002