A 69-year-old man, a heavy drinker and smoker, operated on in 1985 for squamous cell carcinoma of the floor of the mouth and tongue, and underwent haemimandibulectomy with radical dissection of the left neck. In 1996 he underwent reconstruction with free iliac crest graft and titanium rod. In 1999 he underwent a total suprahyoid laryngectomy for a new squamous cell carcinoma of the larynx with left supraclavicular metastasis (T4N1M0). Closure of the pharyngostoma was performed using a dermo-placial-fascial Herrmann flap. She subsequently received radiotherapy treatment with cobalt-60 over the surgical site and bilateral supraclavicular cervical chains. In July 2006 she presented a recurrence of her oral cavity carcinoma, which was surgically treated with resection of the tongue base stump and reconstruction with a left pectoral myocutaneous flap. In November 2006, she was admitted due to the appearance of dysphagia, which resulted in a total inability to eat orally and, secondarily, severe malnutrition. Repeated attempts were made to place a nasogastric tube, without success. A nasofibroscopy was performed which revealed an impassable pharyngo-oesophageal stricture of benign appearance. An oral endoscopy was then requested, which showed a fibrous-looking stenotic area at the pharyngo-oesophageal junction, associated with significant hair growth in the pharynx due to inversion of the skin in the previous surgery, but with no evidence of local tumour recurrence. The oesophageal stricture proved impassable to the endoscope, so a surgical gastrostomy was performed according to the Witzel technique. The patient is currently in an adequate nutritional state and there is no evidence of new tumour recurrence.

