Sextuple Tumors in Head and Neck Area: Evidence of Field Cancerization

Abstract

Background. Field cancerization is a phenomenon in which prolonged exposure to carcinogens induces changes throughout the epithelium leaving the field ready for the appearance of premalignant or malignant lesions. These alterations can promote the development of multiple carcinomas and explain the appearance of recurrences and second primary tumors. The objective of this study was to report the case of a patient who developed six oral cavity tumors in five years of treatment and, also, demonstrate the immunohistochemical changes for p53 and Ki-67, routinely used to assess dysplasic regions. Case Report. When altered, p53 and Ki-67 suggest the presence of field cancers, an area with genetically altered cells, presenting a high risk of developing premalignant and malignant lesions. This phenomenon explains the recurrence of malignant neoplasms after tumor resections. Conclusion. In addition, early identification of potentially malignant lesions in cases of second primary tumors is essential for effective treatment and patient survival, which usually have an unwelcoming prognosis.