Introduction: Squamous cell carcinoma (SCC) is a rare malignancy of invasive epithelium with keratinocyte differentiation, and it is the most common form of eyelid malignant neoplasm, comprising 5-10% of malignancies. While SCC rarely affects the orbit, it may be involved through local invasion from a cutaneous primary site or extension by perineural invasion. Only 11 cases of primary orbital SCC have been reported until now. Here, we present a case of primary carcinoma of the right orbit with coexisting Carney’s syndrome, a rare genetic disorder associated with multiple endocrine neoplasias (MEN) syndromes. Case: A 62-year-old south Asian male presented with a painful swelling in the lateral aspect of the right eyebrow and protrusion of the eyeball in August 2020. He had a history of excision of Right atrial Myxoma in March 2020. Orbital computerized Tomography (CT) and Positron Emission Tomography (PET-CT) scans revealed an enhancing soft tissue lesion in the right orbit with involvement of frontal and ethmoid sinuses. Biopsy confirmed HPV related poorly differentiated squamous cell carcinoma, positive for HPV-related markers. The patient received concurrent chemo irradiation with Cisplatin. Follow-up done PET-CT done 3 months later showed a new lesion appeared in the right orbital region and right lobe of thyroid. Later had surgical excision and total thyroidectomy and Histopathological examination (HPE) from orbit was reported as invasive SCC and from the thyroid was reported as synchronous papillary thyroid cancer. The patient’s proptosis resolved, and subsequent PET-CT and Magnetic Resonance Imaging (MRI) scans did not show any residual or recurrent disease. Conclusion: Primary SCC of the orbit is an extremely rare disease, and this case report presents the 12th reported case and the first one associated with Carney’s syndrome. As there is no standard treatment regimen for primary SCC of the orbit, this case highlights the use of multimodality treatment, including surgical excision and chemo irradiation. The findings emphasize the importance of early detection and management of this uncommon and life-threatening condition, providing hope for patients and aiding in the prevention of recurrence.

Introduction: Primary tracheal carcinoma is a rare and challenging disease that presents significant diagnostic and therapeutic difficulties. Delayed diagnosis due to misinterpretation of airway obstruction symptoms often leads to poorer prognoses for patients. This study aimed to explore the clinical manifestations and multidisciplinary treatment approaches for primary tracheal carcinoma in Bangladesh, with a focus on recent advancements in diagnosis and treatment. Methods: A retrospective observational study was conducted at Bangladesh Specialized Hospital Limited, involving patients aged over 30 who were diagnosed with tracheal carcinoma and underwent multidisciplinary treatment. Data were collected through patient interviews and medical record reviews. Descriptive and inferential statistical analyses were performed to examine demographic characteristics, histological variations, tumor locations, clinical signs and symptoms, treatment approaches, and outcomes. Results: Thirteen patients were included in the study, with a mean age of 49.15±10.50 years. The most common histological variations were invasive squamous cell carcinoma and adenoid cystic carcinoma. The upper trachea was the most prevalent tumor location. Dyspnea, cough, and hemoptysis were the most frequently reported symptoms. Surgical interventions, such as definitive surgery and apple coring surgery, were the primary treatment modalities. Multidisciplinary approaches including Adjuvant / definitive Radiotherapy resulted in a low rate of local recurrence, and patients with successful treatment had better survival outcomes. Conclusion: This study provides insights into the demographic and clinical characteristics of primary tracheal carcinoma in Bangladesh and highlights the importance of a multidisciplinary treatment approach. Further research with larger sample sizes is needed to validate these findings and improve diagnostic and therapeutic strategies for this rare malignancy.

Primary Orbital squamous cell carcinoma is an exceedingly rare condition. This is mainly due to absence of native squamous epithelium of the orbit itself. The number of reported cases of orbital squamous cell carcinoma are very few. The presenting signs and symptoms can sometimes be challenging and diagnosis is difficult. We are presenting a case of primary squamous cell carcinoma in a patient with carneys syndrome and the overall scenario and management is elaborated.