Multiple primary tumors. Four distinct head and neck tumors.

The case history of a 70-year-old woman with the simultaneous occurrence of mucoepidermoid carcinoma of the parotid gland, thyroid carcinoma, squamous cell carcinoma of the oral cavity, and a Warthin tumor is described. The simultaneous occurrence of three histologically distinct malignant tumors is a rare event amounting to approximately 1% of cases of multiple primary tumors. This case is unusual in that the tumors occurred in three separate organs and in association with a papillary cystadenoma lymphomatosum. While difficult to evaluate, prognosis and treatment should be approached with respect to each of the tumors as individual entities.