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Deepak Gupta: Challenging Case Summary – Synchronous Carcinoma Oropharynx and Primary Lung Adenocarcinoma

Deepak Gupta/LinkedIn

May 24, 2025, 13:52

Deepak Gupta: Challenging Case Summary – Synchronous Carcinoma Oropharynx and Primary Lung Adenocarcinoma

Deepak Gupta, Associate Director of the Medanta Hospital (Gurgaon), shared a post on LinkedIn:

“Challenging Case Summary: Synchronous Carcinoma Oropharynx and Primary Lung Adenocarcinoma

• Age: 69 years
• Comorbidities:
o History of left MCA infarct
o On dual antiplatelet therapy
o Chronic smoker

Diagnosis:
1. Primary 1: Carcinoma of the Oropharynx (SCC)
o Stage: T3N1M0
o Histology: Squamous Cell Carcinoma (SCC)
2. Primary 2: Synchronous Lesion in Right Lung
o Stage: T1N0M0
o Histology: Adenocarcinoma

Multidisciplinary Tumor Board Discussion:
• Option A: Radical chemoradiation for oropharyngeal SCC + Surgical resection of lung adenocarcinoma
• Option B: Radical chemoradiation for oropharyngeal SCC + Stereotactic Body Radiation Therapy (SBRT) to lung lesion

Decision:
After weighing comorbidities, functional status, and patient preference, the team proceeded with:

• Radical chemoradiation for oropharynx SCC (70Gy in 35fr Radiation with concurrent Cisplatin)
• SBRT for right lung adenocarcinoma (48Gy in Fractions)

Treatment Course and Outcome:
• Excellent radiological and clinical response at both sites post-treatment
• At 1-year follow-up:
o No evidence of active disease at either site
o Patient maintaining good performance status

Clinical Reflections:

• This case exemplifies a well-coordinated multidisciplinary approach to managing dual primary malignancies.
• Use of non-invasive approach (SBRT to lung and fractionated radiation to HN region) gives excellent outcome with organ sparing.
• Demonstrates that curative-intent treatment can be successful even in complex patients with multiple primary cancers.”