Synchronous triple squamous cell carcinomas of the stomach, skin and gingiva with liver, lung, spleen, kidney, bone and brain metastases: A case report

Synchronous multiple squamous cell carcinomas (SCCs) of the stomach, skin and gingiva are very rare. A 67-year-old male patient was admitted to hospital with progressive chest tightness and fatigue, accompanied by melena. Gastric and dermal biopsies revealed SCCs, and it was considered that triple primary SCCs of the skin, stomach and gingiva had metastasized to the cerebrum, liver, lung, spleen, kidney, bone and subcutaneous tissue. The patient received one cycle of camrelizumab, carboplatin and nab-paclitaxel, followed by two cycles of camrelizumab monotherapy and best supporting care. However, his performance status deteriorated, and he had a very poor survival outcome, succumbing 3 months after diagnosis. Discriminating pathologically between synchronous SCCs in individual organs as metastases or primaries is challenging. In the present case, a diagnosis of triple primary SCCs of the skin, stomach and gingiva with multiple organ metastases was made based on epidemiologic features and clinical presentation. The results of the present case report suggested that anti-programmed death 1 antibodies combined with platinum-based chemotherapy may be a treatment option for metastatic SCC.