Chromium-induced carcinoma in the nasal region. A report of four cases.
The carcinogenicity of chromium is well established in chromium-induced lung cancer. As of yet, however, there have been only few reports of head-and-neck cancer induced by chromium. We report four cases of carcinoma in the nasal region which seemed to be induced by chromium. All patients have worked at the same chromate factory for 19 to 32 years. The first patient has suffered from squamous cell carcinoma of the left nasal cavity, starting 11 years after his retirement. He received radiotherapy followed by surgery. A malignant fibrous histiocytoma occurred in his left upper gingiva in a previously irradiated region, 7 years after the previous treatment. Surgery and chemotherapy for palliation failed to control the tumour, and he eventually expired. The other three patients underwent lobectomy for lung cancer. In cases 2 and 3, the tumour occurred in the left nasal cavity six and ten years, respectively, each after the lobectomy. In case 4, the tumour arose from the nasopharynx 15 years after the lobectomy. These patients are alive and well without any sign of tumour. The presented cases seem to be induced by long-term exposure to chromium. We conclude that regular physical examination of chromate workers is mandatory for the early detection not only of lung cancer but also of head-and-neck cancer.