Multiple primary carcinomas of the upper aerodigestive tract.

Multiple primary squamous cell carcinomas in the upper aerodigestive tract are well described but rare. To be recognised as distinct primary tumours, such malignancies must fulfil a number of anatomical and histological criteria as defined by Warren and Gates. Classification is based on the temporal sequence of tumour diagnosis into three groups; simultaneous, synchronous and metachronous. Second and subsequent primary tumours may escape early detection if not actively searched for. We present a very unusual case of three synchronous tumours in the oral cavity and oropharynx. The literature is reviewed emphasising the importance of thorough investigation of the entire upper aerodigestive tract in patients with a squamous cell carcinoma in this region. Recommendations regarding follow up are also discussed.