Synchronous double primary cancer of the lung and nasal vestibule: A case report and literature review

Abstract

Abstract. Squamous cell carcinoma (SCC) of the nasal vestibule is a rare tumor entity, and its occurrence combined with lung cancer is even rarer. Thus, several patients are often initially misdiagnosed or remain undiagnosed. This is the case report of a 55-year-old male patient who presented to our hospital with a neoplasm in the left lung. The patient was treated with left upper pulmonary lobectomy and the subsequent histopathological examination of the surgical specimen revealed a poorly differentiated SCC. On postoperative week 4, the patient presented with purulent and bloody discharge from the left nostril and was misdiagnosed with an upper jaw cyst. After another 3 weeks, the patient was re-admitted to the hospital with a mass of left nostril and nasal congestion. Tru-Cut biopsies from the nasal area and histopathological examination revealed a moderately differentiated SCC. According to the clinical presentation and the histopathological findings, the patient was diagnosed with double primary cancer of the lung and the nasal vestibule. The mass of the left nostril was significantly reduced in size with radiotherapy. To the best of our knowledge, there is no similar case previously reported in the literature. Due to the rarity of SCC of the nasal vestibule concomittant with lung cancer, we herein present this case report with a review of the relevant literature and investigation of the clinical characteristics. IntroductionMultiple primary cancers are defined as ≥2 separate original cancers, simultaneously or successively occurring in the same or different organs. Double primary cancer is the most common type of multiple primary cancer and it is classified as synchronous carcinoma (SC) and metachronous carcinoma (MC). SC is used to describe the second primary tumor when it is diagnosed simultaneously or within 6 months of the diagnosis of the first primary tumor. MC is is used to describe the second cancer when it is diagnosed >6 months after the first primary cancer (1). The first double primary cancer was reported in 1889 by Billroth (2), whose standard of the diagnosis was that each tumor should have a different localization and independent histological appearance. In 1932, Warren and Gates established new criteria, which are still applied today: i) Both cancers must be definitively malignant according to the histopathological examination; ii) the cancers must be histologically different; and iii) it must be established that the second cancer is not a metastatic lesion of the first (3). The incidence of multiple primary cancers appears to have increased significantly. Approximately 10% of cancer patients develop another primary cancer within 10 years of the first surgery (4). However, double primary cancer of the lung and nasal vestibule is uncommon. We herein describe an extremely rare case of synchronous double primary cancer involving the left nasal vestibule and the left lung, with a review of the literature. Case reportA 55-year-old man presented to the Qianfoshan Hospital on April 8, 2015, where ...