title: Multiple Second Primary Oral Squamous Cell Carcinomas in a Nonsmoker and Nondrinker Woman: Case Report and Review of the Literature.
abstract: This manuscript aims to describe an unusual case of multiple second primary squamous cell carcinomas (SCCs) in several sites of the oral mucosa in a nonsmoker and nondrinker woman and to discuss the diagnostic criteria, clinicopathological aspects and outcome of second primary tumor (SPT).
  
  
  
  Patients treated for SCC of the head and neck are at high risk for developing SPT arising from the same dysplastic mucosal feld. Currently, there is no reliable method to predict which of the patients will develop SPT.
  
  
  
  A 64-year-old nonsmoker and nondrinker woman developed several second primary oral SCCs in 7 years of follow-up, most of them being synchronic, treated by surgery without and with chemotherapy and radiotherapy.
  
  
  
  Patients treated for SCC require a long-term and careful follow-up as the development of SPT contributes with significantly negative impact on the prognosis.
  
  
  
  This report describes the diagnosis and management of a very unusual case of several SPTs affecting different sites of the oral mucosa in the same patient. Moreover, the patient had no apparent risk factors associated with the development of the oral cancer. Therefore, a brief update concerning SPT and its diagnosis and management is also provided.
authors.affiliation: PhD Student, Postgraduate Program in Oral Pathology, Federal University of Rio Grande do Norte, Rio Grande do Norte, Brazil, Phone: 558432154138, e-mail: marialu.diniz@gmail.com.
authors.forename: Maria Luiza Diniz de Sousa
authors.initials: ML
authors.lastname: Lopes
authors.affiliation: Federal University of Rio Grande do Norte, Rio Grande do Norte, Brazil.
authors.forename: Ana Rafaela Luz de
authors.initials: AR
authors.lastname: Aquino
authors.affiliation: State University of Rio Grande do Norte, Rio Grande do Norte, Brazil.
authors.forename: Maria de Lourdes Silva de Arruda
authors.initials: Mde L
authors.lastname: Morais
authors.affiliation: Norteriograndense League against Cancer, Rio Grande do Norte, Brazil.
authors.forename: Lélia Bristo de
authors.initials: LB
authors.lastname: Medeiros
authors.affiliation: Postgraduate Program in Oral Pathology, Federal University of Rio Grande do Norte, Rio Grande do Norte, Brazil.
authors.forename: Éricka Janine Dantas da
authors.initials: ÉJ
authors.lastname: Silveira
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000556:secondary / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D005887:Gingival Neoplasms / Q000175:diagnosis; D006801:Humans; D007972:Leukoplakia, Oral / Q000175:diagnosis; D008207:Lymphatic Metastasis / Q000473:pathology; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000628:therapy; D020360:Neoadjuvant Therapy; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000628:therapy; D010157:Palatal Neoplasms / Q000175:diagnosis; D018714:Radiotherapy, Adjuvant
keywords: Oral cancer; Squamous cell carcinoma; Second primary neoplasms; Treatment outcome; Case reports.