title: Four synchronous cancers in a patient with tongue pain as the only symptom.
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.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Odense University Hospital, Odense, Denmark.
authors.forename: Lene Nyhøj
authors.initials: LN
authors.lastname: Heidemann
authors.affiliation: Department of Oncology, Odense University Hospital, Odense, Denmark.
authors.forename: Jørgen
authors.initials: J
authors.lastname: Johansen
authors.affiliation: Department of Clinical Pathology, Odense University Hospital, Odense, Denmark.
authors.forename: Stine Rosenkilde
authors.initials: SR
authors.lastname: Larsen
authors.affiliation: Department of Plastic and Reconstructive Surgery, Odense University Hospital, Odense, Denmark.
authors.forename: Jens Ahm
authors.initials: JA
authors.lastname: Sørensen
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000532:radiotherapy / Q000601:surgery; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy / Q000601:surgery; D008198:Lymph Nodes; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging* / Q000532:radiotherapy / Q000601:surgery; D008297:Male; D009362:Neoplasm Metastasis; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging / Q000532:radiotherapy / Q000601:surgery; D010146:Pain / Q000209:etiology*; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods; D014062:Tongue Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy / Q000601:surgery; D016896:Treatment Outcome