Head and Neck Imaging

Field cancerization

concept explaining the high incidence of a second malignant mucosal tumour discovered during the diagnostic investigation or follow-up of the first carcinoma in the respiratory tract (Fig.1). Smoking and alcohol abuse irritate the entire mucosa of the respiratory tract, inducing premalignant and malignant lesions. This has led to the concept of 'field cancerization' or 'condemned mucosa', initially published in the context of the oral region, but can be extended to include for the entire head and neck mucosa. The reported frequency of such a second malignant tumour ranges from 10 to 35%.

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Fig.1

Contrast-enhanced CT study performed for staging purposes of a right-sided oropharyngeal squamous cell carcinoma (a, arrowheads). During this study, a second, clinically occult, cancer was detected in the left pyriform sinus (b, arrows).
Field cancerization, Fig.1 (a)
Field cancerization, Fig.1 (b)