Four synchronous cancers in a patient with tongue pain as the only symptom

BMJ Case Rep. 2016 May 5:2016:bcr2015214047. doi: 10.1136/bcr-2015-214047.

Abstract

Synchronous carcinomas may be present in up to 6% of patients with head and neck squamous cell carcinoma (HNSCC) and thus may represent a significant factor in the disease burden. This case report illustrates the importance of a thorough examination of these patients. This patient presented with three synchronous squamous cell carcinomas, two in the tongue and one in the aryepiglottic fold. Positron emission tomography CT (PET-CT) was required for the detection of the carcinomas as the initial MRI and CT scans were inconclusive due to artefacts. Furthermore, PET-CT also revealed increased metabolic activity in the lymph nodes of the neck, which subsequently led to detection of a low-grade follicular lymphoma in addition to the squamous cell carcinomas. These findings support a generous use of PET-CT in patients with HNSCC, at least in those with obvious risk factors.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / diagnostic imaging*
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / surgery
  • Head and Neck Neoplasms / diagnostic imaging*
  • Head and Neck Neoplasms / radiotherapy
  • Head and Neck Neoplasms / surgery
  • Humans
  • Laryngeal Neoplasms / diagnostic imaging*
  • Laryngeal Neoplasms / radiotherapy
  • Laryngeal Neoplasms / surgery
  • Lymph Nodes
  • Lymphoma, Non-Hodgkin / diagnostic imaging*
  • Lymphoma, Non-Hodgkin / radiotherapy
  • Lymphoma, Non-Hodgkin / surgery
  • Male
  • Neoplasm Metastasis
  • Neoplasms, Multiple Primary / diagnostic imaging
  • Neoplasms, Multiple Primary / radiotherapy
  • Neoplasms, Multiple Primary / surgery
  • Pain / etiology*
  • Positron Emission Tomography Computed Tomography / methods
  • Tongue Neoplasms / diagnostic imaging*
  • Tongue Neoplasms / radiotherapy
  • Tongue Neoplasms / surgery
  • Treatment Outcome