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Searching for a Second Primary Tumor

Arch Otolaryngol Head Neck Surg. 1998;124:932-933.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

I appreciate the opportunity to comment on the article by Agrawal and Wenig addressing the relative merits of radiological vs endoscopic evaluation of the esophagus in search for a simultaneous second primary tumor in patients with head and neck cancer. While dynamic imaging using contrast material does provide a substantial amount of information relative to esophageal function as well as variations in anatomy, this study is less helpful than direct visualization when searching for the second primary tumor. As a rule, swallowing disorders are best evaluated using cineoesophagraphy and/or esophagography and mucosal lesions are best evaluated using the endoscope.

Figure appears in full text version. Charles W. Cummings, MD

The process of evaluating a patient who presents with a primary tumor confined to the head and neck using staging endoscopy most assuredly plays a role of extreme importance. Bypassing rigid endoscopic visualization for fiberoptic esophagoscopy substantially mitigates the risks of the procedure. In my hands this . . . [Full Text of this Article]

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