Managing Head and Neck Malignancy Arising in a Field of Crohn Disease Inflammation: Report of a Case

Some of the clinical characteristics of Crohn disease of the head and neck overlap those of squamous cell carcinoma of the head and neck. We describe the diagnostic and therapeutic complexities we encountered in an unusual case of piriform sinus cancer that had arisen in a field of pharyngeal Crohn disease. Based on our initial failure to recognize the predominant inflammatory component of the lesion, we discuss the special considerations that must be made for the detection, staging, and management of head and neck cancer in Crohn disease patients. We further describe the multiple potential interactions among smoking, inflammation, and immunosuppression therapy in the colocalized pathogenesis of the two disease states.