A RESECTED CASE OF SYNCHRONOUS QUADRUPLE CANCER OF THE ORAL CAVITY, PHARYNX, ESOPHAGUS AND STOMACH

Abstract

A 73-year-old man was admitted to the hospital because of a swelling and a pain in the right oral cavity and was diagnosed as having a moderately differentiated squamous cell carcinoma of the oral cavity. Endoscopic examination with screening showed a right pharynx tumor, a thoracic esophageal tumor and a gastric tumor simultaneously. With preoperative diagnosis of synchronous quadruple cancer, systemic chemotherapy and radiation were performed preoperatively. Extirpation of tumors of the oral cavity and pharynx with right neck dissection, thoracic esophagectomy without thoracotomy, total gastrectomy were performed and reconstructed with forearm flap and interposition of transverse colon by posterior mediastinal route. Histologically, the pharyngeal tumor was poorly differentiated squamous cell carcinoma apart from the oral cancer, the esophageal tumor was superficial cancer with m3 invasion diagnosed as moderately differentiated squamous cell carcinoma, and the gastric tumor was poorly differentiated adenocarcinoma. Taken together, they were all solitary carcinoma, not metastatic each other, and the definitive diagnosis of synchronous quadruple cancer was made. We report this extremely rare case of synchronous quadruple cancer of the oral cavity, pharynx, esophagus and stomach resected simultaneously.