Cancer reports (Hoboken, N.J.) · 2026
A Multidisciplinary Approach for a Patient With Synchronous Lip and Thyroid Cancer Involving Radiotherapy.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Nasiek Aleksandra, Polanowski Paweł, Hamm Marek, Kozub Anna, Lipka Barbara, Kotecka-Blicharz Agnieszka, Składowski Krzysztof
Аннотация
BACKGROUND: Synchronous cancers, defined as malignancies diagnosed concurrently or within 2 months of each other, are rare, with an incidence of 1%-6%. Environmental factors such as tobacco smoking play a significant role in their development. Patients with head and neck squamous cell carcinoma (SCC) are at increased risk of second malignancies, complicating treatment strategies and prognosis. This report presents a rare case of synchronous SCC of the lower lip and papillary thyroid carcinoma (PTC).
CASE: A 61-year-old male with a history of smoking presented with a 2.5 cm exophytic lesion of the lower lip, diagnosed as keratinizing SCC. A suspicious cervical lymph node was revealed, which intraoperatively demonstrated metastatic PTC. Following partial lip resection and neck dissection, total thyroidectomy was performed, confirming a 1.5 mm PTC focus with micrometastases. The patient underwent adjuvant conventional radiotherapy (RTH) for SCC (66 Gy in 33 fractions) and radioiodine therapy (131-I) for PTC. Post-therapeutic scintigraphy identified suspected micrometastases in the iliac bone, prompting further 131-I treatment. Following completion of therapy, the patient achieved a complete response, with no radiologic or clinical evidence of residual disease from both malignancies.
CONCLUSION: Synchronous SCC of the lip and PTC are exceedingly rare, lacking standardized treatment guidelines. This case highlights the necessity of a multidisciplinary approach, integrating surgery, RTH, and systemic therapy. Careful postoperative histopathological assessment of lymph nodes may reveal unexpected findings that necessitate further diagnostic work-up and a multidisciplinary approach, as this can significantly influence staging, treatment decisions, and patient prognosis, representing an important key learning point.
CASE: A 61-year-old male with a history of smoking presented with a 2.5 cm exophytic lesion of the lower lip, diagnosed as keratinizing SCC. A suspicious cervical lymph node was revealed, which intraoperatively demonstrated metastatic PTC. Following partial lip resection and neck dissection, total thyroidectomy was performed, confirming a 1.5 mm PTC focus with micrometastases. The patient underwent adjuvant conventional radiotherapy (RTH) for SCC (66 Gy in 33 fractions) and radioiodine therapy (131-I) for PTC. Post-therapeutic scintigraphy identified suspected micrometastases in the iliac bone, prompting further 131-I treatment. Following completion of therapy, the patient achieved a complete response, with no radiologic or clinical evidence of residual disease from both malignancies.
CONCLUSION: Synchronous SCC of the lip and PTC are exceedingly rare, lacking standardized treatment guidelines. This case highlights the necessity of a multidisciplinary approach, integrating surgery, RTH, and systemic therapy. Careful postoperative histopathological assessment of lymph nodes may reveal unexpected findings that necessitate further diagnostic work-up and a multidisciplinary approach, as this can significantly influence staging, treatment decisions, and patient prognosis, representing an important key learning point.