A 69-year-old woman was diagnosed with three concurrent squamous cell carcinomas (SCC) in the same month. Her history includes Sjogren’s syndrome not treated with immunosuppressants and well-controlled type 2 diabetes mellitus. She is a non-smoker. She presented with an ulcerated fungating mass involving the left maxilla and hard palate, confirmed SCC on biopsy. Two weeks prior, she had a right upper lip cutaneous SCC excised. A further right buccal exophytic lesion present for a few weeks was biopsied and confirmed SCC. Staging scans were suspicious for bilateral upper cervical nodal metastasis without distant metastases. Following multidisciplinary discussion and given good premorbid function, she proceeded with curative intent surgery comprising a tracheostomy, left extended maxillectomy, wide local excision of right buccal SCC and bilateral selective neck dissections. Resection was more extensive than planned due to progression of disease, requiring excision of her left cheek skin, oral commissure and upper lip. Reconstruction utilized a local Estlander flap, a free fibula flap and radial forearm free flap. Histopathology demonstrated a T3N0 left maxillary SCC and a T1N0 right buccal SCC. 45 lymph nodes were removed from her right neck, and 39 removed on the left, all negative for metastasis. Margins were clear with no extranodal extension, perineural invasion or lymphovascular invasion. She is planned for adjuvant radiotherapy. This case highlights synchronous SCCs in a patient without typical risk factors. It raises the question of whether chronic autoimmune disease such as Sjogren’s syndrome, even in absence of immunosuppressive therapy, may contribute to oral carcinogenesis. Limited literature exists; one paper finds an elevated risk with Sjogren’s in developing oral lichen planus but does not link it specifically with oral SCC [1]. [1] Owosho A, Oyewole S. Oral Surg Oral Med Oral Pathol Oral Radiol. 2025.