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Case Report
A unique case of triple malignancy of the head and neck region managed successfully in a single surgery
1 MD, Resident-Physician (PGYI), Department of Pathology, Louisiana State University Health Science Center (LSUHSC) Shreveport, Shreveport, Louisiana, USA
2 MD, PhD, Resident-Physician (PGYIII), Department of Pathology, Louisiana State University Health Science Center (LSUHSC) Shreveport, Shreveport, Louisiana, USA
3 MD, Assistant Professor of Pathology, Department of Pathology, Louisiana State University Health Science Center (LSUHSC) Shreveport, Shreveport, Louisiana, USA
4 MD, Clinical Assistant Professor of Pathology, Department of Pathology, Louisiana State University Health Science Center (LSUHSC) Shreveport, Shreveport, Louisiana, USA
Address correspondence to:
Aliaksandr Aksionau
MD, 1501 Kings Hwy, Shreveport, Louisiana 71103,
USA
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Article ID: 100032Z11AA2020
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Aksionau A, Mirza R, Flowers A, Dela Cruz N. A unique case of triple malignancy of the head and neck region managed successfully in a single surgery. J Case Rep Images Pathol 2020;6:100032Z11AA2020.ABSTRACT
Introduction: Head and neck skin tumors usually occur with increasing sun exposure. The most common types are squamous cell and basal cell carcinomas (BCCs). Soft tissue sarcomas of the head and neck region are rare malignancies, especially the leiomyosarcoma (LMS) type. Leiomyosarcoma may appear nonspecific, making diagnosis difficult.
Case Report: We present a unique and interesting case of simultaneous LMS, BCC, and squamous cell carcinoma (SCC) of the head and neck region in a 96-year-old patient. All lesions were excised in the same surgery day with negative surgical margins and diagnosed according to standard protocol.
Conclusion: Basal and SC carcinomas are the most common nonmelanoma skin cancers of the head and neck. Leiomyosarcoma is a rare entity for this region. On extensive literature search, eight cases of the external ear LMS were reported from 1964 to 2019. As a rare type of cancer, it can be misdiagnosed and poorly managed at the beginning, leading to a worse prognosis. In our case, the first line of treatment was surgery with a fairly wide excision of all three tumors. The diagnosis was confirmed by histomorphological evaluation of excised specimens followed by ancillary tests. A synchronous case of LMS, BCC, and SCCs is an exclusive and rare entity that is worth to be studied and reviewed.
Keywords: Basal cell carcinoma, Head and neck tumors, Leiomyosarcoma, Squamous cell carcinoma
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The patient’s confidentiality is fully preserved.
Author ContributionsAliaksandr Aksionau - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Rusella Mirza - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Ashley Flowers - Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Nestor Dela Cruz - Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
