SYNCHRONOUS AND METACHRONOUS MULTICENTRIC SQUAMOUS-CELL CARCINOMAS INTHE UPPER AERODIGESTIVE TRACT

A rare case is presented of a 57-year-old Japanese male with synchrono us and metachronous multicentric squamous cell carcinomas (SCC) in the upper aerodigestive tract, During a g-year-period from the appearance of first primary SCC to autopsy, 14 foci of primary SCC and one sever e dysplasia developed in succession in the thoracic esophagus, oral fl oor, soft palate, uvula, lingual radix, piriform recess, hypopharynx, cervical esophagus, trachea and lingual body, The patient died of seve re bronchopneumonia due to Gramnegative bacterial infection that devel oped as a result of recurrent nerve paralysis. Human papilloma virus a nd Epstein-Barr virus, which are risk factors, were not detected by im munohistochemistry or by the polymerase chain reaction method. Genetic analysis revealed the absence of point mutations in K-ras codon 12. H eavy consumption of alcohol and excessive smoking may have been respon sible for the multicentric carcinogenesis. This is the first case repo rt in the literature of the development of so many primary SCC lesions in the upper aerodigestive tract during such a short period.