Once in a Blue Moon: Second Primary P16-Negative Tonsillar Carcinoma after Temporal Bone Squamous Cell Carcinoma

Second primary malignancy (SPM) is a well-known long-term cause of mortality in head and neck squamous cell carcinoma (HNSCC). The high incidence of head and neck SPM after HNSCC is related to field cancerisation, tobacco and alcohol exposure. Early detection of head and neck SPM is paramount to allow appropriate treatment and have better functional and survival outcomes. Further genomic study is warranted for better understanding about the risk, outcome and to improve survival of SPM. We reported the first case of second primary tonsillar carcinoma that was presented sixteen years after diagnosis of temporal bone squamous cell carcinoma (SCC) in a non-smoker patient. We highlighted the importance of having a long-term surveillance follow up in HNSCC, not only to look for locoregional recurrence and metastases but also to asses for SPM.