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CASE REPORT SECOND NEW PRIMARY OESOPHAGEAL CARCINOMA INCIDENTALLY DIAGNOSED IN A KNOWN CASE OF CARCINOMA CERVIX Dr mayuresh virkar post graduate in department of radiation and oncology, pravara medical trust, loni UNDER GUIDECE OF Dr vandana jain (HOD), MD DR CHAITALI WAGHMARE(MD) Dr. GOPAL PEMMARAJU(MD PG STUDENT) DR SHREYA DWIVEDI (PG STUDENT) DR NAMRATA BHAGAT (PG STUDENT ) Abstract Carcinoma oesophagus in a known case of carcinoma cervix (treated) is extremely rare. We report a case of carcinoma oesophagus incidentally diagnosed on OGD scopy with history of accidental straw ingestion while drinking juice in a treated case of carcinoma cervix. The patient was successfully treated with radical radiation therapy considering as second new primary. Introduction Oesophageal carcinoma is the eight most common cancers and sixth cause of all cancer deaths worldwide.[2] Most of the cases is seen in males with ratio of 4:1 in relation to females[6] Highest incidence is seen in china, Russia, Caspian region of Iran[6]. Squamous cell carcinoma and adenocarcinoma comprise of 95% of all oesophageal cancer, of which 90 percent are squamous cell carcinoma.[1] Over last 20 years there has being increase in the incidence of adenocarcinoma at a rate of 5 % to 10% per year due to exposure to air pollutants. Associated risk factors with carcinoma oesophagus is tobacco, smoking,, alcohol which is associated 80% to90% cases of squamous cell carcinoma [4] Other associated risk factors are Barrett's oesophagus, cardiac achalasia, tylosis. CASE REPORT • A 71 year old lady who was a diagnosed case of carcinoma cervix III B treated in 1997 who was treated with radical chemoradiotherapy at our rural centre. She was on regular follow up for five years. On January 2017 she accidently ingested straw while drinking juice, for which DL scopy and removal of straw was done and DL scopy was done to see the extent of trauma caused by straw. But on DL scopy growth was seen present at 25 cm from incisors. Biopsy from the growth shows moderately differentiated squamous cell carcinoma. On February 2017, after the positive report, patient reported in the department for further management. • Patient was examined for her primary which was under control and all routine haematological and radiological investigations were done. Barium swallow (27/02/2017)- Narrowing of segment seen at thoracic level at T7-T8 VERTEBRA showing shouldering sign with proximal dilatation of oesophagus with mucosal irregularity s/o neoplastic lesion. CT Thorax - neoplastic mass lesion extending from T6 vertebra to GE junction with mediastinal lymphadenopathy • After clinical and radiological work up patient was treated by radiotherapy by 3DCRT to the total dose of 60GY in 30# with concurrent weekly chemotherapy (cisplatin 30 mg/m2). Patient tolerated treatment well. After completion of treatment in April 2017, patient is on follow up CONCLUSION • It has been observed at our rural centre that cancer disease remain unreported in most of the cases as most of them are asymptomatic, neglected and lack of awareness. This case is unique as this patient already had cancer of cervix for which she had taken treatment at our centre in 1997, now she being incidentally diagnosed with second new primary with carcinoma oesophagus and treated well. [ABSTRACT FROM AUTHOR]