Fig. 11

A 75-year-old patient with a previous history of squamous cell carcinoma of the right aryepiglottic fold presented during follow-up with a solitary 2 cm nodule in the right lower lobe. The head-and-neck tumour was treated 8 years before with curative intent. At the time of diagnosis of the SPN, the patient was also diagnosed with a colon carcinoma (adenocarcinoma). Axial CT-image shows an obviously spiculated nodule in the right lower lobe: these findings are suspicious for a second primary rather than solitary metastasis. Histopathologic examination showed a squamous cell carcinoma, with different growth pattern compared to the initial aryepiglottic tumour, making a third primary more likely