Multiple primary oral carcinomas assumed to have
developed from an extensive precancerous lesion
Report of a case.

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Michiko Yoshizawa, Tsutomu Nomura, Masaki Kohno,
Susumu Shingaki, Tamio Nakajima
First Department of Oral and Maxillofacial Surgery,
School of Dentistry, Niigata University.
(chief: prof. Tamio Nakajima)

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Abstract: Multiple primary carcinomas developed from an extensive precancerous lesion is reported. The patient was a 70-year-old woman who complained of burning sensation of the buccal mucosa. A large white lesion was extending from the right buccal mucosa to the lateral border of the tongue. Clinical diagnosis was lichen planus, but histologically, the lesion was diagnosed as epithelial dysplasia. The lesion gradually spread laterally and became erosive with time. Sixteen months later, a tumorous lesion developed in the gingiva of the mandible was diagnosed as squamous cell carcinoma (T₂N₀M₀) by biopsy. It was treated by mandibulectomy and dissection of the submandibular area. Nine months later, the second carcinoma (T₂N₀M₀) was noted in the floor of the mouth. It was removed surgically, but two years later, the third carcinoma (T₁N_2bM₀) with lymph node metastasis developed in the posterior tongue. It was treated by local resection and radical neck dissection. The patient died of multiple metastases. Because all carcinomas were squamous cell carcinomas, they were assumed to have developed multicentrically from the lesion showing epithelial dysplasia.

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