The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 16 , ISSUE 4 ( April, 2015 ) > List of Articles


Multiple Second Primary Oral Squamous Cell Carcinomas in a Nonsmoker and Nondrinker Woman: Case Report and Review of the Literature

Maria Luiza Diniz de Sousa Lopes, Ana Rafaela Luz de Aquino, Maria de Lourdes Silva de Arruda Morais, Lélia Bristo de Medeiros, Éricka Janine Dantas da Silveira

Citation Information : de Sousa Lopes ML, de Aquino AR, de Arruda Morais MD, de Medeiros LB, da Silveira ÉJ. Multiple Second Primary Oral Squamous Cell Carcinomas in a Nonsmoker and Nondrinker Woman: Case Report and Review of the Literature. J Contemp Dent Pract 2015; 16 (4):322-328.

DOI: 10.5005/jp-journals-10024-1684

Published Online: 01-09-2015

Copyright Statement:  Copyright © 2015; The Author(s).



This manuscript aims to describe an unusual case of multiple second primary squamous cell carcinomas (SCCs) in several sites of the oral mucosa in a nonsmoker and nondrinker woman and to discuss the diagnostic criteria, clinicopathological aspects and outcome of second primary tumor (SPT).


Patients treated for SCC of the head and neck are at high risk for developing SPT arising from the same dysplastic mucosal field. Currently, there is no reliable method to predict which of the patients will develop SPT.

Case description

A 64-year-old nonsmoker and nondrinker woman developed several second primary oral SCCs in 7 years of follow-up, most of them being synchronic, treated by surgery without and with chemotherapy and radiotherapy.


Patients treated for SCC require a long-term and careful follow-up as the development of SPT contributes with significantly negative impact on the prognosis.

Clinical significance

This report describes the diagnosis and management of a very unusual case of several SPTs affecting different sites of the oral mucosa in the same patient. Moreover, the patient had no apparent risk factors associated with the development of the oral cancer. Therefore, a brief update concerning SPT and its diagnosis and management is also provided.

How to cite this article

de Sousa Lopes MLD, de Aquino ARL, de Arruda Morais MLS, de Medeiros LB, da Silveira EJD. Multiple Second Primary Oral Squamous Cell Carcinomas in a Nonsmoker and Nondrinker Woman: Case Report and Review of the Literature. J Contemp Dent Pract 2015;16(4):322-328.

PDF Share
  1. P53 mutation in histologically normal mucosa of the aero-digestive tract is not a marker of increased risk for second primary carcinoma in head and neck cancer patients. Eur Arch Otorhinolaryngol 2009;266:547-551.
  2. Second primary cancers in cases of cancer of the buccal mucosa. N Engl J Med 1933;209:1144-1149.
  3. Multiple primary tumours in patients with oral squamous cell carcinoma. Oral Oncol 1999;35:157-163.
  4. Primary and second primary cancer in 649 patients with malignancies of the maxillofacial region. Anticancer Res 2007;27:1805-1818.
  5. Multiple primary malignant tumours. A survey of the literature and a statistical study. Am J Cancer 1932;16:1358-414.
  6. Head and neck squamous cell carcinoma in non-smoking and non-drinking patients with multiple tumors: etiologic significance of p53 and Ki-67 in non-tumorous epithelium. J Oral Pathol Med 2008;37:549-554.
  7. Patient with multiple primary carcinomas including 4 separate oral cancers: study of p53 mutations and their implications for management. J Oral Maxillofac Surg 2006;64:1672-1679.
  8. Field cancerization in oral stratified squamous epithelium. Cancer 1953;6:963-968.
  9. Cancerisation within the oral cavity: The use of ‘field mapping biopsies’ in clinical management. Oral Oncol 2007;43:20-26
  10. Second primary tumours in oral cancer. Oral Oncol 2010;46:426-428.
  11. Squamous cell carcinoma of the head and neck in nonsmorkers and nondrinkers: An analysis of clinicopathologic characteristics and treatment outcomes. Ann Surg Oncol 2003;10(5):551-557.
  12. Second Primary Tumors in Patients with Head and Neck Cancer. Curr Oncol Rep 2011;13:132-137.
  13. Survival of second and multiple primary tumours in patients with oral cavity squamous cell carcinoma in the betel quid chewing area. Oral Oncol 2007;43:811-819.
  14. Second malignant neoplasms following radiotherapy. Int J Environ Res Public Health 2012;9(12):4744-4759.
  15. Trends over three decades of the risk of second primary cancer among patients with head and neck cancer. Oral Oncol 2013;49(1):9-14.
  16. Use of external beam radiotherapy is associated with reduced incidence of second primary head and neck cancer: a seer database analysis. Int J Radiat Oncol Biol Phys 2008;71(1):192-198.
  17. Association of HPV infections with second primary tumors in early-staged oral cavity cancer. Oral Dis 2012;18(8):809-815.
  18. Second primary cancers after an index head and neck cancer: subsite-specific trends in the era of human papillomavirus-associated oropharyngeal cancer. J Clin Oncol 2011;29(6):739-746.
  19. p53 expressions: predicting recurrence and second primary tumors in head and neck squamous cell carcinoma. J Natl Cancer Inst 1996;88(8):519-529.
  20. Genetic profile of second primary tumors and recurrences in head and neck squamous cell carcinomas. Head Neck 2012;34(6):830-839.
  21. Clinical and prognostic value of [18F] FDG-PET for surveillance of oral squamous cell carcinoma after surgical salvage therapy. Oral Oncol 2006;42:297-305.
  22. Survival study and treatment strategy for second primary malignancies in patients with head and neck squamous cell carcinoma and nasopharyngeal carcinoma. Acta Otolaryngol 2007;127:651-657.
  23. Incidence of second primary tumours in patients with squamous cell carcinoma of the tongue. Br J Oral Maxillofac Surg 2011;49(1):50-52.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.