In the modern era, there is an increase in the incidence of double malignancies owing to the remarkable improvement in cancer diagnostics and patient survival. Double malignancies can be either synchronous or metachronous. Synchronous double malignancy can present either at the same time or within 6 months of diagnosis of the first one. We present a case of double malignancy of lip and submandibular salivary gland, diagnosed in a 55-year-old male, who presented with ulceroproliferative lesion of the upper lip and a hard swelling in the right submandibular gland. The tissue diagnosis was suggestive of squamous cell carcinoma of the lip and mucoepidermoid carcinoma of the submandibular gland. The patient underwent successful wide local excision of the lip and submandibular gland along with prophylactic supraomohyoid neck dissection. This case is reported for the rarity in site and histopathology of double malignancy.

OBJECTIVE: To report a case of an elderly patient with an unstable mental condition, presenting with the carcinoma of lip due to repeated toothpick injury.
BACKGROUND: Self-induced lesions of the face and mouth may be a manifestation of unusual or aggressive oral habits or an emotional disorder. The deliberate creation of orofacial lesions, is an indication of underlying psychiatric disease. Betel quid chewing is the major risk factor for oral cancer. It conditions the oral mucosa towards the development of cancer. Repeated trauma by self mutilation on such a conditioned mucosa can lead to the development of cancer.
METHODS: A male patient aged 85 years reported the complaint of a growth on the left side of the lower lip. Trauma followed by self inflicted injury had predisposed to the formation of cancer.
CONCLUSIONS: Diagnosis of self inflicted lesions are challenging as the histories of these lesions tend to be vague and misleading. Our knowledge in this particular pathology is limited mainly because of diagnostic difficulties and lack of solid statistical data.