Triple Primary Head and Neck Cancer : A Case Report and Literature Review

Abstract

Globally, head and neck cancer is estimated to occur in more than 700,000 patients a year and cause 400,000 deaths and second most common cancer in India among both sexes and all ages. Even after optimal treatment for primary cancer, there are cases where second primary cancers develop around the previously treated areas. This occurrence is explained by the concept of field cancerization, which refers to a term where a carcinogen such as tobacco when chewed, exposes the mucosa to the carcinogen starting from the oral cavity to the upper aerodigestive tract. Combinations of two primary malignancies are seen in around 3% to 5% of patients, combinations of three cancers in about 0.5%, and combinations of four malignant tumors in about 0.3% of patients with a previous history of cancer. Early diagnosis and detection of these cancers are necessary for optimal treatment as with each occurrence the tolerability and the response rates gets poorer.