Synchronous Squamous Cell Carcinoma Research Articles

Synchronous primary squamous cell carcinomas in the upper aerodigestive tract with differing histological features and metastatic spread: A case report

Synchronous primary squamous cell carcinomas in the upper aerodigestive tract with differing histological features and metastatic spread: A case report

Synchronous Squamous Cell Carcinoma of Tongue and Papillary Carcinoma of Thyroid - A Rare Case Report

Synchronous Squamous Cell Carcinoma of Tongue and Papillary Carcinoma of Thyroid - A Rare Case Report

下顎歯肉扁平上皮癌と頸部原発悪性リンパ腫の同時性重複がんの1例

下顎歯肉扁平上皮癌と頸部原発悪性リンパ腫の同時性重複がんの1例

Toxicities of the anti-PD-1 immune checkpoint antibody nivolumab in the acute inpatient setting.

227 Background: Knowledge of immune-system regulation led to the discovery of immune checkpoints molecules, which have demonstrated anti-tumor activity across various malignancies. These advances represent a new set of challenges for clinicians, including non-oncologists treating the cancer patient, who must develop a working knowledge of the mode of action of these agents, their unique response kinetics, and how to diagnose and effectively manage their toxicities. Nivolumab is a monoclonal immune checkpoint antibody that binds to the PD-1 receptor on T-cells, blocking PD-1 pathway-mediated anti-tumor immune response inhibition. Methods: Review of current literature and analysis of 3 cases of patients with Nivolumab-related toxicities at a major cancer center. Results: Case #1: 74 years-old female with NSCLC who was started on nivolumab after developing disease progression with various regimens. Nivolumab was held 4 months later due to development of erythematous, edematous papules and plaques, with overlying ulcerations and crust in forearms, thighs and trunk. Also, paronychias and loss of nail beds in both great toes. She developed no new lesions after discontinuation of immunotherapy. Case #2: 71 years-old male with right lung NSCLC, started on Nivolumab after evidence of disease progression after completion of carboplatin/paclitaxel. Four months later developed grade 2 Nivolumab-induced pneumonitis; this was withheld and ultimately discontinued due to persistent pneumotoxicity in spite of corticosteroids. Case #3: 41 years-old male with synchronous right lung ALK-positive adenocarcinoma, on crizotinib, and left lung squamous cell carcinoma, on nivolumab. He developed nivolumab-induced ANCA-negative glomerulonephritis, which was discontinued while continuing the crizotinib. His renal function normalized 3 months later, with GFR going from 14 to 122. Conclusions: Most adverse events with the anti-PD-1 agent Nivolumab are generally reversible after discontinuation of therapy, yet some high-grade immune-related adverse events require management with corticosteroids and other immune modulating agents. Further research is needed.

Synchronous papillary urothelial carcinoma of the bladder and squamous cell carcinoma with sarcomatoid differentiation: A case report.

The incidence rate of multiple primary tumors is 37% in all types of cancer. A patient diagnosed with primary cancer is 1.29 times more likely to develop an additional primary cancer when compared with the general population. Furthermore, in patients diagnosed with primary cancer, the possibility of a secondary malignancy in the same or different organ is increased. Following the identification of a secondary tumor, the risk of relapse or metastasis must be considered. The present study reports the case of a 76-year-old man who was admitted to Sakarya University Training and Research Hospital (Sakarya, Turkey) with swelling of the head, which had been apparent for 15 days. An excisional biopsy of the temporal region was performed and was used to diagnose the patient with synchronous squamous cell carcinoma with sarcomatoid differentiation of the scalp. The patient was referred to the Department of Plastic Surgery (Sakarya University Training and Research Hospital) for resection; however, he refused treatment and was subsequently discharged. To the best of our knowledge, this patient represents the first case of synchronous skin malignancy and urothelial carcinoma of the bladder to be reported in the literature.

Synchronous lymphoma and metastatic squamous cell carcinoma in a patient with bilateral abnormal axillary lymph nodes

Synchronous lymphoma and metastatic squamous cell carcinoma in a patient with bilateral abnormal axillary lymph nodes

Management of synchronous panfacial fractures and oral squamous cell carcinoma

Management of synchronous panfacial fractures and oral squamous cell carcinoma

A Presentation of Multiple Primary Squamous Cell Carcinoma in the Oral Cavity

Multiple primary oral squamous cell carcinomas (SCCs) are uncommon in clinical practice. In this report, we describe 3 synchronous SCCs. A 65-year-old female non-smoker was referred to our facility for evaluation of a SCC on the soft palate. Intraoral examination revealed 2 other erythematous lesions (on the border of the tongue and lower gingiva). Erythroplakia and SCCs were suspected. Incisional biopsies were performed, and the diagnosis was SCC in both lesions. The treatment consisted of anterior marginal mandibulectomy; left partial glossectomy; and hard and soft palate resection with skin free flap reconstruction. In addition, the patient was referred for adjuvant radiotherapy. This case shows a complete diagnosis performed by stomatologists, which led to appropriate treatment.

Quantification of tumor infiltrating Foxp3+ regulatory T cells enables the identification of high-risk patients for developing synchronous cancers over upper aerodigestive tract

Patients with squamous cell carcinomas (SCC) of upper aerodigestive tract, either over head and neck (HNSCC) or esophagus (ESCC), frequently developed synchronous multiple cancers, leading to worse prognosis. This study validated whether suppression of host cancer immunosurveillance mediated by regulatory T cells (Treg) may predispose to the development of synchronous cancers. Tumor tissues of 200 patients (100 ESCC only, 50 HNSCC only, and 50 synchronous SCCs) were quantitatively accessed for the tumor infiltrating Treg by immunohistochemistry. The density of Treg was also correlated to the level of Treg-associated inhibitory cytokines (IL-10, IL-35 and TGF-β1), and chemokine (CCL22). The density of tumor infiltrating Treg in the index tumor (i.e. the first malignancy diagnosed) of synchronous SCC group was higher than those of HNSCC or ESCC only (p<0.05). Selecting the optimal cut-off value of Treg density as 34.6 cells/mm(2) by ROC curve, an increased Treg density of the index tumor can be an independent factor for developing synchronous SCCs (OR: 6.13; 95% CI: 2.84-13.26). The Treg density was positively correlated with serum IL-10 level and the degree of CCL22-positive cells infiltration in tumor. Furthermore, the serum inhibitory cytokine IL-10 level was higher in synchronous SCC than in non-synchronous ones (p<0.001), that indicated the cellular immunosuppression in patients with synchronous cancers. A more severe defect in cellular immunity may predispose to multifocal tumor. The Treg cell number in SCC may serve as a novel predictive biomarker for the risk of synchronous cancer development to initiate a proper surveillance program.

Simultaneous Occurrence of a Large Asymptomatic Prolapsing Left Atrial Myxoma with a Cutaneous Squamous Cell Carcinoma

Synchronous myxoma of the heart and other malignancies are extremely rare. We report a case of a 64-year-old man who had a large left atrial myxoma that obstructed the mitral valve, as well as an unrelated, coexistent cutaneous squamous cell carcinoma in the sacral area. During the preoperative evaluation for non-cardiac surgery, the tumor was diagnosed coincidentally by echocardiographic examination. Echocardiography findings were consistent with a large left atrial myxoma originating from the posterior wall and prolapsing into the left ventricular cavity through the mitral valve, causing mitral stenosis. The mass was successfully completely excised. Histologic examination of the mass confirmed the diagnosis of cardiac myxoma. We report a casual echocardiographic finding of a left atrial myxoma that obstructed the mitral valve outflow tract, and an unrelated, synchronous cutaneous squamous cell carcinoma in the sacral area.

A Report on Synchronous Polymorphous Low-grade Adenocarcinoma and Unknown Primary Squamous Cell Carcinoma

ABSTRACT Background This is a case report of synchronous, noncollision head and neck malignancies, consisting of a large polymorphous low-grade adenocarcinoma (PLGA) and an unknown primary squamous cell carcinoma (SCC) that was diagnosed on final pathology. Materials and methods Positron emission tomography– computed tomography (CT) scan with and without contrast was obtained, which showed a large destructive soft tissue mass emanating from the right maxilla into the right maxillary sinus with invasion into the surrounding tissue and bone, compatible with an underlying primary maxillary malignancy. Increased D-18 fluorodeoxyglucose activity was also seen in the neck corresponding to numerous bilateral cervical lymph nodes. Magnetic resonance imaging showed the extent of the soft tissue mass, which expanded to the inferior aspect of the right orbital floor, with no evidence of gross invasion into the orbit. Results The patient underwent a subtotal maxillectomy, bilateral modified radial neck dissection, and reconstruction. Pathology revealed metastatic PLGA present in the right cervical lymph nodes. Left cervical lymph nodes, however, revealed metastatic SSC. The patient was taken back to the operating room and a panendoscopy was performed. Physical examination was benign and multiple biopsies were negative for SSC. The patient underwent radiation therapy for PLGA and unknown primary SSC antigen. Conclusion Synchronous tumors of the head and neck are seldom reported and they present unique treatment challenges. This case report discusses the diagnosis, management, and unique nature of two malignant synchronous noncollision tumors in the head and neck. How to cite this article Fisher AD, McClure SA, Franco J. A Report on Synchronous Polymorphous Low-grade Adenocarcinoma and Unknown Primary Squamous Cell Carcinoma. Int J Head Neck Surg 2015;6(4):181-186.

Localized synchronous squamous cell carcinomas of the esophagus and hypopharynx treated with definitive concurrent chemoradiotherapy with a unified radiotherapy plan.

Because of common risk factors, synchronous squamous cell carcinomas of the esophagus and head and neck are common, and their concurrent presence can significantly complicate disease eradication and survival. Here, we report the case of a patient with a history of extensive tobacco and alcohol use who was diagnosed with a localized thoracic esophageal squamous cell carcinoma, and in whom positron-emission tomography-computed tomography discovered a nearby asymptomatic localized hypopharyngeal focus that was confirmed by biopsy to also be malignant. He was treated with definitive concurrent chemoradiotherapy in a single unified radiotherapy plan, with surgery reserved for salvage treatment. He currently remains in remission without a need for surgical salvage. However, significant concern remains for both treatment failure and development of another primary because of "field cancerization."

Nasal endoscope: an armamentarium in the management of sinonasal inverted papilloma.

Sinonasal inverted papillomas (SIP) are unique group of locally aggressive benign neoplastic lesions arising from mucosa of sinonasal tract with potential for recurrences and known association with squamous cell carcinoma in 5-15% of cases. This study was conducted was to assess the efficacy and usefulness of the nasal endoscope in treating SIP. We reviewed 28 biopsy proven cases of SIPs that were treated at our hospital between June 2009 and September 2013. Average patient age was 46years. Fourteen were treated by transnasal endoscopic excision of tumor with noted recurrence of 21.43%. Thirteen were treated by endoscopic assisted open surgery which had 23% recurrence. Three patients had malignant inverted papillomas, of whom two (7%) were found to have synchronous squamous cell carcinoma and one (3.6%) had metachronous squamous cell carcinoma. No evidence of recurrence was found in rest during our follow up. The endoscopic approach is the preferred method for the treatment of the majority of inverted papillomas. Powered instrumentation is extremely useful to achieve good results. Although significant number of cases was done by external approach by lateral rhinotomy, the endoscopic assistance is required to ensure complete removal of the tumour to reduce the recurrence rates. Close follow up of the patient for a longer period of time is necessary for the early detection of recurrence and to allow for surgical salvage.

Synchronous multiple oral squamous cell carcinomas: Report of a case

Long-term survival of head and neck cancer patients has not significantly improved in the last 30-year, in spite of advances in therapy. An important reason for this lack of progress is the development of second primary tumors (SPTs) in the upper aerodigestive tract. To account for the development of multiple (multicentric) primary tumors in the oral cavity, the concept of field cancerization by Slaughter can be interpreted in various ways to explain this phenomenon of SPTs. The frequency of developing synchronous and metachronous carcinomas in the head and neck mucosal sites ranges from 8% to 21%. These SPTs are usually more aggressive, more treatment resistant, and metastasizes early, requiring a more aggressive treatment strategy and hence the early detection is important. Here, we report a case of synchronous oral squamous cell carcinomas in a female patient, which was poorly differentiated histologically and was confirmed by immunohistochemical analysis.

Synchronous HPV-Positive Squamous Cell Carcinoma of the Bilateral Base of the Tongue

Although there have been several reports of synchronous Human Papillomavirus (HPV)-associated tonsillar carcinoma, no reports have shown synchronous HPV-associated Base of The Tongue (BOT) carcinoma. Here we discuss a case of synchronous HPV-associated BOT carcinoma and review the literature concerning HPV-associated second primary tumors. We report the case of a 59-year-old man with synchronous HPV-positive Squamous Cell Carcinoma (SCC) of the bilateral BOT. Both BOT SCCs were positive for HPV16. The patient received concomitant cisplatin radiotherapy, and remains disease-free at 18 months post-treatment.

Synchronous Esophageal and Laryngeal Squamous Cell Cancers: A Case Report

Introduction: It is well recognized that individuals with squamous cell carcinoma (SCC) of the upper aero-digestive tract are at risk for subsequent tumors. Furthermore, careful evaluation for synchronous SCC is a critical aspect of management. We present the unusual case of an individual with three separate primary tumors diagnosed at a single upper endoscopy. Case Presentation: The patient is a 61-year-old male who complained of gradually progressive dysphagia to solids for 3 months. This was accompanied by 30-pound weight loss in the previous 6 months and hoarseness of voice for 2 weeks. He had a 50-pack year cigarette smoking history and 40 years of moderate alcohol consumption. An older sibling had died of SCC of the larynx in his 70s. Examination was notable for cachexia and pulmonary signs of emphysema. Lab studies were unremarkable. EGD was done which showed three different lesions: a laryngeal mass involving the left side of the epiglottis and the supra-glottic larynx, a 2 x 1 cm esophageal mass at 25 cm from incisors, and another distal esophageal fungating mass extending between 30 and 40 cm from the incisors. The stricture caused by the latter lesion was likely the cause of his dysphagia. There was normal esophageal mucosa in between the two esophageal masses. Biopsies were taken from the esophageal masses, and the patient was sent for ENT evaluation of the laryngeal mass. Pathology results confirmed invasive SCC of the larynx and both sites in the esophagus. CAT scan of the chest, abdomen and pelvis was negative for any metastatic disease. The patient was treated with cisplatin and 5-FU as well as radiation therapy for T3N0M0 SCC of the esophagus and larynx. Repeat endoscopy 4 months later showed post-radiation changes, with no tumor detectable on biopsies. Conclusion: Synchronous primary SCC of the esophagus and larynx are very uncommon. As smoking and alcohol consumption are common and synergistic risk factors for aero-digestive tract cancers, physicians should have a high index of suspicion for the possibility of synchronous or metachronous primary cancers of the upper GI and respiratory tract in these patients. This case is unusual in that three separate SCCs presented simultaneously, and highlights the need to screen at-risk mucosa at presentation. Vigilance for subsequent SCC should also be maintained. Early diagnosis of these malignancies can lead to significant benefit in morbidity and mortality with treatment.

Su1957 Clinical Outcomes of Synchronous Esophageal Squamous Cell Carcinoma and Gastric Adenocarcinoma According to Method of Treatment

Su1957 Clinical Outcomes of Synchronous Esophageal Squamous Cell Carcinoma and Gastric Adenocarcinoma According to Method of Treatment

Synchronous Verrucous Carcinoma and Squamous Cell Carcinoma of Penis by Different Human Papillomavirus Infections

Synchronous verrucous carcinoma and squamous cell carcinoma of the penis is a rare condition. We report on a case of penile carcinoma with a well demarcated and ulcerated endophytic squamous carcinoma lesion by human papillomavirus 16 and 61 types, and a whitish exophytic verrucous carcinoma lesion by an unknown lower risk human papillomavirus type.

Synchronous BALT Lymphoma and Squamous Cell Carcinoma of the Lung: Coincidence or Linkage?

A 72-year-old man presented with weight loss, fever, and malaise. Chest radiograph and CT revealed two large ill-defined masses in middle and left lower lobes. CT-guided biopsy of left lower lobe mass disclosed bronchus-associated lymphoid tissue (BALT) lymphoma. Middle lobe mass was considered second deposit in contralateral lung. The patient received chemotherapy for BALT. Followup CT disclosed regression of left lower lobe mass and stability of middle-lobe mass and of right paratracheal lymph nodes. CT-guided biopsy of middle-lobe mass revealed squamous cell lung carcinoma. Surgical biopsy of right paratracheal lymph nodes revealed malignancy. Disease was staged T3, N2, and M0. Combined chemotherapy for lung cancer and BALT lymphoma was initiated.

Synchronous primary neoplasms of the bladder, skin and breast in a male patient: a case report

The incidence of multiple primary malignant neoplasms increases with age, reflecting an increase in overall cancer risk in older patients. Cases of two or more concurrent primary cancers are still rare, although its incidence is increasing. Here, we report the case of a 57-year-old man who was referred to our institution with synchronous squamous cell carcinoma of the skin on the forehead, infiltrating ductal carcinoma of the breast, and transitional cell carcinoma of the urinary bladder. To the best of our knowledge, this is the first reported case in literature of this combination of primary neoplasms.