Section: 
Diseases of the lymphoepithelial pharyngeal ring and neck
Diseases of the lymphoepithelial pharyngeal ring and neckRare case of metachronous primary multiple malignant neoplasms localized in ent organs
V. V. Vinogradov (1), S. S. Reshul’skii (2), M. L. Isaeva (3), A. A. Grigor’eva (4), A. A. Gorina (5)
(1), (2), (3), (4) National Medical Research Center of Otolaryngology of the Federal Medical and Biological Agency of Russia, Moscow, 123182, Russian Federation, (1), (2), (5) Pirogov Russian National Research Medical University, Moscow, 117997, Russian Federation, (1), (4) Russian Medical Academy of Continuous Professional Education, Moscow, 125993, Russian Federation
UDK: УДК 616.322-006.6:615.849
DOI: https://doi.org/10.18692/1810-4800-2026-3-23-28
ABSTRACT
Abstract. Introduction. Primary multiple malignant neoplasms of the oropharynx are rare, especially in the metachronous form. Diagnosis of oropharyngeal cancer is difficult because of the similarity of symptoms with chronic inflammatory diseases, which leads to late detection (79.6% of cases are at stages III–IV). Radiation therapy for the first tumor is an additional risk factor for the development of a second neoplasm. Methods. The article presents a clinical case of an 84-year-old female patient who presented with complaints of pain, scratching, and a dry throat for 3 years, with a suspected oropharyngeal neoplasm. She has a history of reticulosarcoma of the left palatine tonsil with damage to the cervical lymph nodes (1972), which received radiation therapy (total dose 54 Gy). The following procedures were performed: ENT panendoscopy, contrast-enhanced computed tomography, and extended multifocal biopsy under endotracheal anesthesia. Results. Endoscopy and CT scan revealed a widespread tumor lesion of the posterior and lateral walls of the oropharynx with infiltration of the aryepiglottic, glossoepiglottic folds, epiglottis, and narrowing of the pyriform sinuses. Histologically verified squamous cell keratinizing carcinoma G1. The diagnosis was stage IV oropharyngeal cancer (T4N0M0). Surgery is not indicated. Conclusion. Long-term, atypical, and treatment-resistant inflammatory changes in the oropharynx require increased cancer alertness, especially in patients with a history of previous malignant neoplasms and radiation therapy. ENT panendoscopy is a highly informative method for assessing the prevalence of the tumor process.
Publication date:
16.06.2026
Keywords:
primary multiple malignancies, metachronous tumors, oropharyngeal cancer, radiation therapy, reticulosarcoma of the palatine tonsil, cancer alertness For citation:
Vinogradov V. V., Reshul’skii S. S., Isaeva M. L., Grigor’eva A. A., Gorina A. A. Rare case of metachronous primary multiple malignant neoplasms localized in ent organs. Russian Otorhinolaryngology. 2026;25(3):23-28. (In Russ.) https://doi.org/10.18692/1810-4800-2026-3-23-28