Simultaneous Triple Primary Head and Neck Malignancies: A Rare Case Report

Abstract

The occurrences of multiple primary malignant tumours in the head and neck region are reported as simultaneous, synchronous, or metachronous based on their chronology of presentation. Lymphoid malignancies presenting in association with squamous cell carcinoma in the head and neck region are extremely rare. We report a case of a 71 year old male patient with simultaneous triple primary malignancies of different histologic origin, involving larynx (squamous cell carcinoma), thyroid (papillary thyroid carcinoma) and lymph nodes (non-Hodgkin's lymphoma).

Keywords: Head and neck malignancies; Simultaneous; Triple primary malignancies.

Fig. 1

a CECT of the neck showing right side thyroid nodule (single black arrow); there is extralaryngeal spread of squamous carcinoma of larynx with involvement of strap muscle (double black arrows); b Histopathology of larynx specimen showing invasive squamous cell carcinoma; c Histopathology of thyroid specimen (low power field, 2.5X) showing papillary architecture (asterisk); d Histopathology of thyroid specimen (high power field, 40X) showing follicular cells with enlarged nucleus, optically clear nuclear inclusion, grooving (single black arrow); overlapping of nuclei (double black arrows)

Fig. 2

Histopathology of lymph nodes showing nodal marginal zone lymphoma with plasmacytic differentiation. a Effacement of lymph nodal architecture by small, monomorphic neoplastic cells with round to irregular nuclei, indistinct nucleoli, abundant pale to clear cytoplasm and distinct border; b Showing neoplastic cells positive for CD20; c Plasmacytoid cells staining for CD138; d Neoplastic cells negative for CD5, while paracortical T-Cell nodule staining for CD5 (single black arrow)