# Is There an Association between a Tonsillar Diffuse Large B-Cell Lymphoma Arising after a Neck Squamous Cell Carcinoma of Occult Primary? A Case Report and Extensive Literature Review

## TL;DR

This paper reports a case where a patient with a neck squamous cell carcinoma later developed tonsillar diffuse large B-cell lymphoma, suggesting a possible link.

## Contribution

The novelty lies in highlighting the potential association between head and neck irradiation and subsequent lymphoma development in patients with occult primary cancers.

## Key findings

- A patient with occult primary neck squamous cell carcinoma later developed tonsillar diffuse large B-cell lymphoma.
- The lymphoma was initially misdiagnosed as a recurrence of the original cancer.
- The case underscores the need for long-term follow-up in patients with occult primary cancers.

## Abstract

Objectives: The aim of this review is to focus on the possibility of patients with squamous cell carcinoma to develop a second primary disease such as DLBCL, perhaps because of the irradiation of the head and neck area. Materials and methods: A case of an 89-year-old man is reported, who initially underwent surgical and complementary treatment for neck squamous cell carcinoma of occult primary and later for tonsillar diffuse large B-cell non-Hodgkin lymphoma. Results: The second primary was considered a recurrence in the neck of the original cancer of unknown primary, so a new surgical management was decided. The final pathology report described a diffuse large B-cell non-Hodgkin lymphoma. Conclusions: The importance of maintaining follow-ups for patients with occult primary cancers who are at an elevated risk of developing a metastasis or a second primary carcinoma outbreak is highlighted.