Naseem, R

Abstract Introduction Synchronous carcinomas are second neoplasms that occur within 6 months of the primary lesion. After this period, they are considered metachronous neoplasms. Literature reported the incidence of synchronous and metachronous carcinoma in the oral cavity from 8% to 21% which is a poor prognostic factor with a subsequently poor overall survival rate. Case Report A 57-year-old male presented with ulcerative lesions in the oral cavity for the last 2 years. He had 25-year history of betel nut chewing. On examination, two ulcerative lesions noted in the oral cavity: on the right upper gingival area measuring approximately 1 x 1 cm with the exposed underlying bone, and another on the left lower gingival area measuring 2 x 2 cm from canine to premolar, subsequently confirmed with MRI. Biopsy confirmed squamous cell carcinoma (SCC). After discussion in the multidisciplinary meeting, he underwent right partial maxillectomy, left marginal mandibulectomy, bilateral neck dissection, and dental extractions, with uneventful post-operative recovery. Histopathology of right partial maxillectomy was moderately differentiated SCC (pT4a), Left marginal mandibulectomy; well-differentiated SCC in the canine area, as well as molar teeth area, and no involved lymph nodes (0/88). All resection margins were free of tumour. Radiotherapy was given to the right maxilla postoperatively. Conclusions To our knowledge, this is the first reported case of triple synchronous SCC oral cavity in our country. Detection of three Synchronous SCCs in the oral cavity follows the concept of field cancerization. A multidisciplinary treatment strategy in a high-volume cancer-dedicated centre is required to aggressively treat such tumours.