Author(s) :

Mara, Ioana-Maria , Monica.

Volume/Issue :

Abstract :

The occurrence of multiple primary cancers in patients is increasing. Esophageal cancer is the ninth most common cancer globally. Esophageal squamous cell carcinoma (ESCC) is often associated with a head and neck second primary malignancy (HNSPM, which worsens prognosis. This case report highlights a 54-year-old male with ESCC presenting as a tumor in the middle third of the thoracic esophagus, accompanied by progressive dysphagia and significant weight loss. Initial staging identified the esophageal tumor as cT4N0Mx in conformity with American Joint Committee on Cancer (AJCC 7). A subsequent PET-CT revealed a secondary mass at the oropharyngeal level, confirmed as squamous cell carcinoma (SCC) via biopsy. Treatment included neoadjuvant chemoradiotherapy with Carboplatin and Paclitaxel, alongside 54 Gy radiotherapy targeting the esophageal tumor. Post-treatment imaging demonstrated regression of the esophageal tumor, but without clinical and imagistic response of the oropharyngeal tumor. Definitive radiotherapy with concurrent Cetuximab was initiated for the oropharyngeal SCC, but due to skin toxicity (grade 3 radioepitheliitis) a 7 day treatment break was needed. Follow-up CT imaging revealed a favorable response of the oropharyngeal tumor.There is no surgical indication because the oropharyngeal tumor is central. Prospective studies are essential to evaluate the impact of such strategies on survival outcomes.

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