From a 9-year Veterans Administration Medical Center experience, 34 patients were identified who had synchronous or metachronous pulmonary lesions in association with primary head-neck carcinoma. Evaluation of the pulmonary lesions included bronchoscopy, mediastinoscopy, and thoracotomy. Lung lesions were felt to be metastatic lesions from head and neck primary in 12 patients, primary lung carcinoma in 20 patients, and metastases from subdiaphragmatic primary neoplasms in two patients. This study demonstrates that head-neck carcinoma may spread to the lung but that associated lung lesions are most commonly second primary neoplasms.
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