THE OCCURRENCE of multiple primary neoplasms in the same or different organ systems in a patient is not uncommon.1-4The incidence of multiple malignancies in autopsy material has been reported as high as 6.8%.5In selected clinical situations the incidence is even higher.6Surgeons and radiotherapists, who see a large number of patients with laryngeal carcinoma, are aware of the high frequency of a second primary occurring in the lung.7,8 When the lung is second of the two organs involved, the issue as to whether or not the lung lesion represents a metastasis must be considered. In 1941 Braund and Martin9pointed out that metastases below the clavicle from a laryngeal tumor was rare without extensive involvement of the cervical lymph nodes. This impression was corroborated by Latella10in the study of the terminal phase of 240 patients with carcinoma of the larynx when
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Joseph Sherman (1967) studied this question.
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