Hypopharyngeal cancer is relatively rare, accounting for about 0.8%~1.5% of head and neck malignant tumors. Since the hypopharynx is a relatively insensitive area, early tumors are not easy to be detected, and about 40% of patients consult the doctor because of the discovery of metastatic lymph nodes in the neck. An example is reported below. 1. Clinical information The patient is a 64-year-old female, farmer and illiterate. In November 2008, she unintentionally found a left lower neck swelling, gradually increasing, such as the size of a walnut, without cough, fever and other physical discomfort, she consulted the Department of Surgery of a county hospital in Cangzhou City, Hebei Province, and was examined for a left lower neck supraclavicular swelling of 4cm×4cm in size, hardness, and poor mobility, and no abnormalities were seen in the neck and thorax CTs. He was admitted to the hospital with “neck mass” and underwent surgery under local anesthesia to remove the mass. During the operation, the mass was found to be adherent to the blood vessels in the neck and could not be completely removed, so partial excision was performed to close the incision, and the pathology was sent to the hospital for examination: epithelial-myoepithelioma, which was diagnosed as “primary tumor of the neck”. He was diagnosed as “primary tumor of the neck”. The patient was recuperated outside the hospital, and the left lower neck mass enlarged progressively, and was treated with antibiotic infusion on his own with no obvious effect. At the beginning of January 2009, the patient had difficulty in swallowing, which was obvious when eating lumpy dry food, not accompanied by choking on drinking water and hoarseness, so she consulted the hospital again, and was diagnosed as “left lower neck supraclavicular region palpated with a lump, about egg size, hard, poor activity, no pressure pain, no adhesion to the skin, and surgical healing scar was visible on the surface of the lump, about 7cm in length”, and underwent esophageal examination. There was no abnormality in barium esophagography (smooth wall, regular mucosal folds, normal peristalsis, and no obvious niches or filling defects), and the results of esophageal scraping taken by fiber-optic esophagoscopy showed that the squamous epithelium had atypical hyperplasia grade I. The diagnosis of “esophageal cancer” was made on the basis of the results of fiber-optic esophagoscopy. She was diagnosed as “esophageal cancer with supraclavicular lymph node metastasis”, and was given one cycle of chemotherapy with CBF program (CTX+BLM+5-FU), with no symptomatic relief, and her efficacy was evaluated as NC (WHO standard for evaluating the efficacy of solid tumors.) In March 2009, the patient visited our hospital, and in order to make a definitive diagnosis, she had a review of the CT report of the neck. “In order to clarify the diagnosis, the patient reviewed the CT report of the neck, which showed a mass in the posterior wall of the pharynx, invading the entrance of the esophagus, and a cauliflower-like mass in the posterior wall of the pharynx and the entrance of the esophagus, and biopsy: adenocarcinoma (Department of Pathology, our hospital). The diagnosis was “adenocarcinoma of the hypopharynx with esophageal invasion and cervical lymph node metastasis”. Because the family thought that the patient was older and weaker, the family refused surgical treatment, and the department gave radiation therapy (DT6400cGy/32 times, 1 time/day, 5 times/week), and concurrent chemotherapy with a PF regimen (DDP75mg/m2, IV, day 1; 5-5-mg/day, day 1). day 1; 5-Fu1000mg/m2, continuous IV, days 1-4) for one cycle, three days after the end of radiotherapy, the neck mass was found to have shrunk by about 30%, and the symptoms of dysphagia were gradually relieved, and the efficacy was evaluated to be PR (WHO criteria for evaluating the efficacy of solid tumors). Three weeks after the end of radiotherapy, the patient came to the hospital for review, the left lower neck mass shrunk about 60%, dysphagia symptoms disappeared, and it was recommended that the patient continue to undergo chemotherapy for 4-5 cycles, but the patient and his family gave up the treatment for economic reasons and lost the follow-up. 2, Discussion The hypopharynx is the continuation part of the oropharynx, located at the back and sides of the larynx, starting from the pharyngeal epiglottic folds and ending at the lower edge of the cricoid cartilage, which is connected to the entrance of the cervical esophagus. It is clinically divided into 3 regions: the pyriform fossa region, the posterior cricoid region, and the posterior pharyngeal wall.There is no obstacle between the 3 regions, and the hypopharyngeal wall consists of mucosa, fibrofascia, muscle, and loose connective tissues, with a thickness of less than 1 cm, which is almost incapable of preventing the infiltration of tumors. About 95% or more of hypopharyngeal carcinomas are squamous carcinomas and are poorly differentiated. Rare pathological types include adenocarcinoma of minor salivary gland origin, as well as malignant melanoma, malignant lymphoma, and soft tissue sarcoma, and occasionally metastatic tumors. Comparatively speaking, hypopharyngeal carcinoma originating from the posterior wall of the pharynx has the lowest degree of cell differentiation, followed by carcinoma of the pyriform fossa, while carcinoma of the posterior cricoid region has a relatively good degree of cell differentiation. Therapeutic principle: It is necessary to maximize the rate of local-regional control of the tumor and minimize the degree of damage to organ function caused by therapeutic means. Generally, for early stage lesions, surgery or treatment is chosen alone, and combined treatment is avoided. Patients with intermediate and advanced stages need multidisciplinary integrated treatment, mainly radiotherapy plus surgery, and if there are distant metastases, chemotherapy is usually the main treatment, supplemented by radiotherapy or surgery. Patients who cannot tolerate surgery and are in poor physical condition should be treated with simple radiotherapy. In recent years, due to the wide application of auxiliary medical examination equipment, the diagnosis of clinical diseases has become easier, faster and clearer. Clinicians should communicate closely with auxiliary departments and should not overly mechanically trust the auxiliary examination reports, but should constantly enhance their own judgmental and analytical abilities, and exert their subjective initiative, so as to enable tumor patients to be detected, diagnosed and treated at an early stage.