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Gastroenterology Research and Practice
Volume 2013, Article ID 236264, 5 pages
Clinical Study

Chromoendoscopy to Detect Early Synchronous Second Primary Esophageal Carcinoma in Patients with Squamous Cell Carcinomas of the Head and Neck?

1Department of Otorhinolaryngology, University Hospital Ostrava, 708 52 Ostrava, Czech Republic
2Faculty of Medicine, University of Ostrava, 703 00 Ostrava, Czech Republic
3Department of Internal Medicine, City Hospital Frýdek-Místek, 738 01 Frýdek-Místek, Czech Republic
4Department of Gastroenterology, Vítkovice Hospital Ostrava, 703 00 Ostrava, Czech Republic
5Department of Oncology, University Hospital Ostrava, 708 52 Ostrava, Czech Republic

Received 12 January 2013; Accepted 25 February 2013

Academic Editor: Bjørn Moum

Copyright © 2013 Pavel Komínek et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To evaluate the use of flexible esophagoscopy and chromoendoscopy with Lugol’s solution in the detection of early esophageal carcinomas (second primary carcinomas) in patients with squamous cell carcinoma of the head and neck (HNSCC). Methods. All patients with newly diagnosed HNSCC underwent office-based Lugol's chromoendoscopy. After flexible esophagoscopy with white light, 3.0% Lugol's iodine solution was sprayed over the entire esophageal mucosa. Areas with less-intense staining (LVLs) were evaluated and biopsies taken. Results. 132 patients with HNSCC were enrolled in this study. The most frequent primary tumors were oropharyngeal (49/132), tumors of the oral cavity (36/132), and larynx (35/132). The majority of subjects (107/132 patients, 81.1%) had advanced HNSCC carcinomas (stages III and IV). Multiple LVLs were discovered in 24 subjects (18.2%) and no LVLs in 108 (81.8%) subjects. Fifty-five LVL biopsy specimens were obtained and assessed. Squamous cell carcinomas were detected in two patients, peptic esophagitis in 11 patients, gastric heterotopic mucosa in two patients, hyperplasia in two patients, and low- and high-grade dysplasia in three patients. Conclusion. Although only two patients with synchronous primary carcinomas were found among the patients, esophagoscopy should be recommended after detection of HNSCC to exclude secondary esophageal carcinoma or dysplasia.