Laryngeal Carcinoma Associated With Multiple Additional Primary Tumors

\s=b\Four malignant tumors and one benign in a 76-year-old man appeared. Three of the neoplasms were in the respiratory system, and one was a bladder carcinoma; all were linked to heavy smoking habits. The patient underwent immunologic investigations consisting of in vivo testing for cutaneous reactivity, in vitro lymphocyte blastogenesis studies, Tand B-cell level studies, and serum immunoglobulin level studies. The studies have demonstrated anergy to recall antigens, decreased lymphocyte responses to phytohemagglutinin, and low levels of peripheral T-lymphocytes. The serum immunoglobulins were at the upper limit of the normal. The relationship between the patient's immunologic status and the occurrence of multiple primary neoplasms is discussed. (Arch Otolaryngol 103:550-552, 1977) Multiple primary neoplasms in one patient have been reported pre¬ viously. The majority of publications report two primary malignant neo¬ plasms. Billroth et al' reported several cases of second primary tumor almost a century ago; however, these were regarded as curiosities. Today it is known that up to 11% of cancer patients develop more than one pri¬ mary lesion.'- With increasing longevi¬ ty and improved diagnostic and treat¬ ment techniques, patients cured of one cancer may develop additional malignant neoplasms. The present study reports the immune responses of a patient with multiple primary malignant neo¬ plasms. The results have shown increased cell-mediated immunity functions. Few studies have been reported until now concerning the im¬ mune functions of these patients.3"7