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En las últimas décadas se ha experimentado un aumento progresivo de dobles neoplasias primarias del tracto aerodigestivo, concretamente de las dobles neoplasias pulmonares primarias (DNPP) y dobles neoplasias primarias de laringe y pulmón. Tras realizar una revisión bibliográfica actualizada sobre el tema, se aporta la experiencia de los autores en tres casos de DNPP y 11 casos de DNP laringe-pulmón, atendidas durante un período de 18 años.
En los casos de DNPP, el 66% de los pacientes estaban en estadio I y el 34% en estadio II. Todos los casos de primera neoplasia pulmonar primaria (PNPP) eran escamosos con grado de diferenciación G1 en el 66% y G2 en el 34%; así mismo la presentación de la segunda neoplasia primaria (SNP) fue metacrónica en el 66% y sincrónica en el 34%.
Cuando las DNP eran de laringe-pulmón se observó una afectación laríngea en el 81% de las PNP; todos los casos fueron escamosos en su primera presentación con un grado G1 en el 72%, perteneciendo al estadio I un 80% y al II un 20%; las presentaciones metacrónicas llegaron al 63% y las sincrónicas al 37%.
La supervivencia global (desde la PNP) es 1,3 veces mayor que la supervivencia siguiente a la SNP, cuando se trató de DNPP; mientras que en las DNP laringe-pulmón, la supervivencia global es 2,7 veces mayor que la siguiente a la SNP.
During the last decades, the incidence of double primary neoplasms (DPN) of the digestive tract has progressively increased, specially the incidence of DPN of the lung and DPN of the larynx and lung. This study reports a bibliographic revision of the literature and the clinical experience of the authors based in three cases of DPN of the lung and 11 cases of DPN of the lung and larynx observed during a period of 18 years. Patients with DPN of the lung were at stage I in 66% of instances and at stage II in the remaining 34%. All cases of first primary pulmonary neoplasm were of the squamuous cell type with a differentiation degree G1 in 66% of cases and G2 in 34%. The presentation of the second primary neoplasm was metachronous in 66% and synchronous in 34%. In patients with DPN of the lung and larynx, laryngeal involvement in cases of primary pulmonary neoplasms was 81%. At the first presentation, all cases were of the squamous type with a differentiation degree G1 in 72%, stage I in 80%, stage II in 20%, metachronous presentation in 63%, and synchronous presentation in 37%. In cases of DPN of the lung the overall survival (since the occurrence of the first pulmonary neoplasm) was 1.3 times higher than the survival after the second neoplasm, whereas in cases of DPN of lung and larynx, the overall survival was 2.7 times higher than that following the second neoplasm.
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