Second Primary Subglottic Laryngeal Carcinoma After Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone (CHOP) Chemotherapy for Non-Hodgkin Lymphoma

Second primary malignancies are a recognised late complication in lymphoma survivors, particularly in those treated with alkylating agents and topoisomerase II inhibitors. While therapy-related haematological malignancies are well documented, solid tumours of the head and neck remain uncommon. We report the case of a 72-year-old man with a history of stage IV high-grade non-Hodgkin lymphoma, most likely diffuse large B-cell lymphoma (DLBCL) based on morphology, treated with eight cycles of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) chemotherapy in 2018. He achieved remission but returned five years later with progressive hoarseness and stridor. Emergency tracheostomy was performed for airway stabilisation. Contrast-enhanced CT revealed an enhancing subglottic lesion with extension into the glottis, and biopsy confirmed moderately differentiated squamous cell carcinoma. The absence of conventional risk factors such as tobacco or alcohol use favoured a therapy-related pathogenesis. To our knowledge, this is the first reported case of subglottic squamous cell carcinoma arising after CHOP chemotherapy for non-Hodgkin lymphoma in the absence of conventional risk factors. This underscores the importance of lifelong vigilance in lymphoma survivors and the prompt evaluation of new airway symptoms to enable timely diagnosis and potentially curative treatment.