Synchronous Laryngeal Primary Cancer in a Patient with Esophageal Squamous Carcinoma Cell: A Case Report

Case Report

Austin Med Sci. 2023; 8(1): 1073.

Synchronous Laryngeal Primary Cancer in a Patient with Esophageal Squamous Carcinoma Cell: A Case Report

Ouhammou Y*; Gridda M; Maouni I; Yaka M; Njoumi N; Zentar A; Ait Ali A

Department of Visceral Surgery, Military Hospital Mohammed V, Faculty of Medicine and Pharmacy of Rabat, Morocco

*Corresponding author: Ouhammou Y Department of Visceral Surgery, Military Hospital Mohammed V, Faculty of Medicine and Pharmacy of Rabat, Morocco. Email: ouhammouyousra2017@gmail.com

Received: March 31, 2023 Accepted: May 05, 2023 Published: May 12, 2023

Abstract

Unexpected diagnosis of primary synchronous cancer in a patient with esophageal squamous carcinoma cell makes therapeutic management difficult. The careful evaluation of synchronous tumors is a primority aspect of management. we present the unusual case of an individual with esophageal squamous carcinomas cell synchronously associated with another primary laryngeal tumor. Initial clinical assessment was performed and consisting in a pan endoscopy and FDG-Pet scan / CT revealed the presence of Synchronous Head and Neck and Esophageal Carcinoma (SHNEC). As recommended in the literature, surgical resection was not indicated. In this case radio chemotherapy often remains the only therapeutic alternative which guarantees a better result and improves the prognosis. The patient progressed well under concomitant radio chemotherapy even if complications inherent to this treatment required the cessation of treatment for a short period.

Keywords: Synchrounos squamous cell carcinoma; Radio chemotherapy

Introduction

Synchronous esophageal and laryngeal Squamous Cell Carcinoma (SCC) have been increasing due at improvements diagnostic technique [1]. The association between different SCC can be explained by chronic exposition to common carcinogens agents “tobacco and alcoholism” [2], This exposition responds to the concept of (the field cancerization) induced tumor formation through DNA methylation and epigenetic alteration The incidence of esophageal and laryngeal squamous cell carcinoma in morocco is approximately 1,2% [3] the presence of simultaneously malignancy of the upper aero-digestive is a critical aspect of diagnosis and management; however, this is facilitated by the advent of the FDG-PET scan and panendoscopy standard modality of staging and diagnosis.

Therapeutically, Curative Chemoradiotherapy (CCRT) is best alternative treatment of synchronous SCC locally advanced and non operable tumors, the surgical treatment endowed death complication, unfortunately CRT necessity the delivery of high dose radiation causing the tissue toxicity. SCC with early involvement lymph node renders it extremely aggressive with a high mortality.

Case Report

A 62 years old man, having as risk factors a regular consumption of tobacco and alcohol, without notion of hereditary disease. He presented to the gastroenterology department complaining of progressive dysphagia for solid foods and hoarseness of the voice for 2 months, with weight loss for 4 months. Physical examination revealed general cachexia with no other physical signs. Laboratory results showed mild anemia with a hemoglobin of 9.6g/dl, serum tumor markers (scc, cyfra 21-1) were elevated. Gastroduodenoscopy of the esophagus revealed an irregular circumferential ulcerative lesion located 35 cm from the dental arch. Naso pharyngo endoscopy revealed a left subglottic laryngeal tumor mass. Thoraco-abdominal CT scan showed a circumferential thickening of the thoracic esophagus with a height of 70 mm from the subcarinal region and measuring 15mm in thickness, with several pulmonary aortic and left intrabronchial Hilar lymph nodes measuring (20/6 mm). In addition, at the cervical level, CT imaging showed a polyploid mass; CT-AP imaging: no secondary metastasis (Figure 1); FDG-PET/CT (Figure 2): demonstrates focal intense FDG avidity over the esophagus, left epiglottis and mediastinal lymph nodes. The diagnosis of squamous cell carcinoma of the esophagus and larynx was confirmed by histopathology.