Hisao Shigematsu

An extremely rare case of metachronous multiple primary cancers of the tongue, breast, and gingiva is reported. A 61-year-old man was referred to our hospital because of a tumor of the tongue in June 2005. A clinical diagnosis of tongue cancer (T2N0M0) was made, and the patient underwent a partial glossectomy for the tongue cancer. Histopathological examination revealed a well-differentiated squamous cell carcinoma (SCC). In September 2006, left breast cancer was suspected on FDG PET-CT examination (max SUV=2.5). Physical examination showed an elastic hard mass, measuring 2.4 × 2.0 cm, under the nipple. Mammography and fine needle aspiration cytology revealed a breast cancer. A clinical diagnosis of T4bN0M0 was made, and a left mastectomy and sentinel lymph node biopsy were performed. The histopathological diagnosis was an invasive duct carcinoma (pT4bN0). HER2 was positive (HER2-FISH). Hormone receptor evaluation (Allred score) was estrogen receptor (ER) 8 and progesterone receptor (PgR） 4. Endocrine therapy with anastrozole was indicated and given for 5 years. In June 2014, an ulcerative lesion was seen on the left mandibular gingiva. A clinical diagnosis of gingival cancer (T1N0M0) was made, and marginal resection of the mandible was performed. The histopathological diagnosis was moderately differentiated SCC. The postoperative course was uneventful. There has been no evidence of recurrence, metastasis, or another primary cancer.

Chronic expanding hematoma （CEH） is a lesion that develops gradually after trauma or surgery. Generally, it arises in the pleural cavity, lower leg, abdomen, or backj occurrence in the head and neck region is uncommon.We report a case of CEH arising in the maxillary sinus of a 47-year-old man who was referred to our hospital for further evaluation of a lesion in the left maxillary sinus. No subjective symptoms were reported at presentation, and he had no remarkable family or past medical history. Panoramic X-ray films showed a radiopaque domeshaped mass in the left maxillary sinus, and computed tomographl demonstrated a well-circumscribed round lesion. The lesion, which was clinically diagnosed as a maxillary tumor, was resected under general anesthesia. Histopathological examination revealed that the tumor consisted of an inner layer of hematoma with capillaries, a middle layer of granulation tissue, and an outer layer of dense fibrous connective tissue with calcification. The histopathological diagnosis of the lesion was CEH. There was no sign of recurrence 19 months after the operation.