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Chen Y, Luo S, Zheng Q, Yu Q, Liu C, Tang R, Chen F, Zhang Y. A case of metachronous triple primary carcinoma complicated with pulmonary tuberculosis: Case report and review. Medicine (Baltimore) 2024; 103:e39638. [PMID: 39312323 PMCID: PMC11419472 DOI: 10.1097/md.0000000000039638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Accepted: 08/20/2024] [Indexed: 09/25/2024] Open
Abstract
RATIONALE Multiple primary malignant neoplasms with tuberculosis are rare. The interaction between tuberculosis and tumor remains unclear. Moreover, the treatment of multiple primary tumors combined with tuberculosis is relatively complicated. Herein, we report a case of metachronous triple primary carcinoma complicated with pulmonary tuberculosis. OBJECTIVE This report aims to analyze the clinical characteristics of 3 primary tumors combined with tuberculosis. We report the long-term survival of this patient after personalized treatment and this patient have a good quality of life. DIAGNOSES AND INTERVENTIONS A 55-year-old male patient was diagnosed with squamous cell carcinoma of the lower thoracic esophagus (cT4bN1M0 IVA) and received concurrent chemoradiotherapy, followed by 2 cycles consolidate chemotherapy. During the follow-up, he was diagnosed with secondary tuberculosis (TB) and accepted anti-TB treatment. During anti-TB treatment, he was diagnosed with squamous cell carcinoma of the oropharynx (cT1N0M0 I P16(-)), then he received radical radiation therapy. However, within a year, the patient was diagnosed with oral squamous cell carcinoma (cT3N0M0 IIIA). He accepted an individualized chemotherapy with paclitaxel combined with capecitabine. Moreover, immunohistochemistry of the patient's 3 biopsies indicated positive P53 expression. OUTCOMES Since the patient suffered from esophageal cancer, oropharyngeal cancer, and oral floor cancer, no tumor recurrence or metastasis was observed. And he has a good quality of life. Tuberculosis, TP53 mutation, radiotherapy, smoking, and drinking history may be risk factors for multiple primary tumors. LESSONS The treatment of multiple primary tumors combined with pulmonary tuberculosis is complicated. Individualized treatment allows patients to achieve long-term survival while also having a good quality of life. Limitations in this case: surgery may be an alternative strategy for the patient, but the patient refused surgery.
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Affiliation(s)
- Ying Chen
- Department of Oncology, Suining First People’s Hospital, Suining, China
| | - Shu Luo
- Department of Oncology, Suining First People’s Hospital, Suining, China
| | - Quan Zheng
- Department of Respiratory Medicine, Suining First People’s Hospital, Suining, China
| | - Qing Yu
- Department of Pathology, Suining First People’s Hospital, Suining, China
| | - Chunxia Liu
- Department of Oncology, Suining First People’s Hospital, Suining, China
| | - Rui Tang
- Department of Oncology, Suining First People’s Hospital, Suining, China
| | - Fei Chen
- Department of Oncology, Suining First People’s Hospital, Suining, China
| | - Yan Zhang
- Department of Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, China
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2
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Salhab RQ, Ghazaleh ZI, Barbarawi W, Salah-Aldin R, Hour H, Sweity R, Bakri IA. An unusual occurrence of multiple primary malignant neoplasms: a case report and narrative review. Front Oncol 2024; 14:1381532. [PMID: 39087028 PMCID: PMC11288870 DOI: 10.3389/fonc.2024.1381532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 06/26/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction Multiple primary malignant neoplasms (MPMNs) are cancers presenting distinct pathological types that originate from different tissues or organs. They are categorized as either synchronous or metachronous. Nowadays, the incidence of MPMN is increasing. Patients and methods We present a case of a 71-year-old male patient with a medical history of hepatitis B and a family history of breast and endometrial cancers. The patient reported a nasal tip skin lesion with recurrent bleeding, and the history disclosed lower urinary tract symptoms. Further investigations revealed the coexistence of four primary cancers: basosquamous carcinoma of the nasal lesion, prostatic adenocarcinoma, hepatocellular carcinoma, and clear cell renal cell carcinoma. Results A multidisciplinary team cooperated to decide the proper diagnostic and therapeutic modules. Conclusion To the best of our knowledge, the synchronization of these four primary cancers has never been reported in the literature. Even so, multiple primary malignant neoplasms, in general, are no longer a rare entity and need proper explanations, a precise representation of definition and incidence, further work-up approaches, and treatment guidelines as well.
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Affiliation(s)
- Rawand Qasim Salhab
- Medical Research Club, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Zeina Ihab Ghazaleh
- Medical Research Club, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Wadee Barbarawi
- Department of Urology, Al-Makassed Islamic Charitable Hospital, Jerusalem, Palestine
| | - Riyad Salah-Aldin
- Department of Urology, Al-Makassed Islamic Charitable Hospital, Jerusalem, Palestine
| | - Hani Hour
- Department of Oncology, Beit Jala Hospital, Bethlehem, Palestine
| | - Raghad Sweity
- Medical Research Club, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Izzeddin A. Bakri
- Department of Pathology, Al-Makassed Islamic Charitable Hospital, Jerusalem, Palestine
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Ishida N, Nagata K, Fukuda J, Oguma Y, Hirashima T, Minami K, Nishimura Y, Matsuo Y. Stereotactic body radiation therapy for multiple lung cancers in a patient with six primary cancers: a case report. J Med Case Rep 2024; 18:316. [PMID: 38987857 PMCID: PMC11238481 DOI: 10.1186/s13256-024-04633-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 05/31/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Surgery is the standard care for patients with early-stage lung cancer, and stereotactic body radiation therapy is an option for those who are medically inoperable or refuse surgery. Medical developments in diagnostic and therapeutic strategies would prolong prognosis of patients with cancer. The number of patients with multiple cancers has also increased. Duplex primary malignant neoplasms are the most common, and triple or more primary malignant neoplasms were extremely rare. This is the first case of sextuple primary malignant neoplasms with lung cancer. CASE PRESENTATION We report a case of two courses of stereotactic body radiation therapy for an 88-year-old Japanese male patient with six primary cancers in five organs. Cancers were detected in the thyroid, prostate, esophagus, bladder, and lungs. He also had a history of angina pectoris and had undergone percutaneous coronary intervention. Although he was capable of undergoing surgery for lung cancers, he refused it because he had experienced many invasive treatments, such as surgeries and percutaneous coronary intervention. In January 2020, the first stereotactic body radiation therapy was performed for the adenocarcinoma in the right lung. In March 2022, the second stereotactic body radiation therapy was performed for the nodule of the left lung. Although he complained of mild dyspnea after the first stereotactic body radiation therapy, we did not use steroids because his peripheral oxygen saturation was within the normal range. He had pleural effusion, cardiac dilatation, and pericardial effusion 2 months after the second stereotactic body radiation therapy, which improved with the use of compression stockings. CONCLUSION A total of 43 and 17 months have passed since the first and second stereotactic body radiation therapy, respectively, there is no local recurrence and the patient can walk independently. We safely performed stereotactic body radiation therapy twice for our older patient with metachronous early-stage lung cancers. If another new tumor is detected, stereotactic body radiation therapy would be a good treatment option for the functional preservation of organs.
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Affiliation(s)
- Naoko Ishida
- Department of Radiation Oncology, Kindai University Faculty of Medicine, 377-2 Onohigashi, Osaka-Sayama, Osaka, 589-8511, Japan
- Department of Radiation Oncology, Ishikiriseiki Hospital, 18-28 Yayoi-cho, Higashiosaka, Osaka, 579-8026, Japan
| | - Kenji Nagata
- Department of Radiation Oncology, Ishikiriseiki Hospital, 18-28 Yayoi-cho, Higashiosaka, Osaka, 579-8026, Japan.
| | - Jyunki Fukuda
- Department of Radiation Oncology, Kindai University Faculty of Medicine, 377-2 Onohigashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Yasuo Oguma
- Department of Radiation Oncology, Kindai University Nara Hospital, 1248-1 Otoda Town, Ikoma, Nara, 630-0293, Japan
| | - Tomonori Hirashima
- Department of Thoracic Oncology, Ishikiriseiki Hospital, Higashiosaka, Japan
| | - Kenichi Minami
- Department of Respiratory Medicine, Ishikiriseiki Hospital, Higashiosaka, Japan
| | - Yasumasa Nishimura
- Radiation Therapy Center, Fuchu Hospital, 1-10-17 Hiko Town, Izumi, Osaka, 594-0076, Japan
| | - Yukinori Matsuo
- Department of Radiation Oncology, Kindai University Faculty of Medicine, 377-2 Onohigashi, Osaka-Sayama, Osaka, 589-8511, Japan
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Wang R, Cai H, Liu C, Lv Z, Ma C. Two Cases of Synchronous Hodgkin Lymphoma and Papillary Thyroid Carcinoma in 18 F-FDG PET/CT. Clin Nucl Med 2024; 49:650-651. [PMID: 38689445 DOI: 10.1097/rlu.0000000000005261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
ABSTRACT The concurrence of Hodgkin lymphoma and papillary thyroid carcinoma is a rare clinical event. Two women presented with a painless mass in the neck that was suspected malignancy by ultrasonography. Both cases shown in the 18 F-FDG PET/CT images demonstrated multiple foci of increased FDG uptake in the neck, mimicking thyroid carcinoma with contralateral cervical lymph node metastases. Unexpectedly, the postoperative pathologies confirmed the thyroid lesion of papillary carcinoma and contralateral cervical lymph nodes of classical Hodgkin lymphoma.
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Affiliation(s)
- Ru Wang
- From the Department of Nuclear Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University
| | - Haidong Cai
- From the Department of Nuclear Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University
| | - Changcun Liu
- Department of Nuclear Medicine, Shanghai First People Hospital, Jiao Tong University School of Medicine, Shanghai, China
| | - Zhongwei Lv
- From the Department of Nuclear Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University
| | - Chao Ma
- From the Department of Nuclear Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University
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Aminian S, Al-Alloosh F, Yadegari F, Zarinfam S, Al-Abedi HH, Majidzadeh-A. K. Quadruple Primary Malignancies over 2 Years with Germline Mutation in Krebs Cycle Enzyme Gene Fumarate Hydratase. Case Rep Genet 2024; 2024:5591237. [PMID: 38873645 PMCID: PMC11175842 DOI: 10.1155/2024/5591237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 05/01/2024] [Accepted: 05/20/2024] [Indexed: 06/15/2024] Open
Abstract
Multiple primary cancers (MPCs) are defined as the presence of more than one cancer in an individual that is not due to recurrence, metastasis, or local spread. Different factors such as copathogenic genetic mutations, environmental factors, lifestyle, and first cancer treatment increase the possible occurrence of subsequent malignancies. In recent years, the risk of MPCs has increased due to improved treatment; however, quadruple primary malignancies are still rare and require further investigation and treatment of the underlying cause. Here, we present a 64-year-old man with a 40-year history of cigarette smoking who developed quadruple primary malignancies of the epiglottis, kidney, pancreas, and lung. To investigate the possible genetic cause, we performed WES, and a variant of c.580G > A (Ala194Thr) was discovered in exon 5 of the Krebs cycle enzyme gene, fumarate hydratase (FH). This substitution was classified as VUS in Clinvar and likely pathogenic by Varsome and Franklin software. The structural analysis showed that the variation found was localized in a highly conserved alpha helix in the D2 domain near the FH hinge region (<6 Å), suggesting that enzyme activity was affected by a perturbation in protein quaternary structure. Because of the well-established role of FH mutations in renal cancer risk, it was possible that the FH mutation could have led to the development of renal cell carcinoma in this case. The biological mechanisms of MPCs suggest that subsequent primary malignancies are triggered by the combined effects of environmental factors, such as smoking and genetics.
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Affiliation(s)
- Solaleh Aminian
- Genetics Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | | | - Fatemeh Yadegari
- Genetics Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Shiva Zarinfam
- Genetics Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | | | - Keivan Majidzadeh-A.
- Genetics Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
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Al-Ibraheem A, Abdlkadir AS, Al-Adhami DA, Lopci E, Al-Omari A, Al-Masri M, Yousef Y, Al-Hajaj N, Mohamad I, Singer S, Sykiotis GP. Comparative analysis through propensity score matching in thyroid cancer: unveiling the impact of multiple malignancies. Front Endocrinol (Lausanne) 2024; 15:1366935. [PMID: 38894738 PMCID: PMC11184125 DOI: 10.3389/fendo.2024.1366935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 05/22/2024] [Indexed: 06/21/2024] Open
Abstract
Background The incidence of thyroid cancer is on the rise worldwide, with childhood exposure to radiation being the sole acknowledged catalyst for its emergence. Nonetheless, numerous other factors that may pose risks are awaiting thorough examination and validation. This retrospective study aims to explore the malignancies linked to thyroid cancer and contrast the survival rates of those afflicted with a solitary tumor versus those with multiple primary neoplasms (MPN). Methods This retrospective study examined data from King Hussein Cancer Center (KHCC), Jordan. Among 563 patients diagnosed with thyroid cancer, 30 patients had thyroid malignancy as part of MPN. For a 1:3 propensity score-matched analysis, 90 patients with only a primary thyroid malignancy were also enrolled. Results Hematologic and breast malignancies were among the most frequent observed cancers alongside thyroid neoplasm. Patients who had MPN were diagnosed at older age, had higher body mass index and presented with higher thyroglobulin antibody levels (p < 0.05 for each). Additionally, MPN patient displayed a stronger family history for cancers (p= 0.002). A median follow-up duration of 135 months unveiled that MPN patients faced a worse 5-year survival compared to their counterparts with a singular neoplasm (87% vs 100% respectively; p < 0.01). However, no distinction emerged in the 5-year event-free survival between these two groups. Conclusion MPN correlates with a significantly altered survival outcome of thyroid cancer patients. The diagnosis of thyroid carcinoma at an older age, accompanied by elevated initial thyroglobulin antibody levels and a notable familial predisposition, may raise concerns about the potential occurrence of synchronous or metachronous tumors.
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Affiliation(s)
- Akram Al-Ibraheem
- Department of Nuclear Medicine, King Hussein Cancer Center (KHCC), Amman, Jordan
- Division of Nuclear Medicine, Department of Radiology and Nuclear Medicine, the University of Jordan, Amman, Jordan
| | - Ahmed Saad Abdlkadir
- Department of Nuclear Medicine, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Dhuha Ali Al-Adhami
- Department of Nuclear Medicine, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Egesta Lopci
- Nuclear Medicine Unit, IRCCS– Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
| | - Amal Al-Omari
- Office of Scientific Affairs and Research (OSAR), King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Mahmoud Al-Masri
- Department of Surgery, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Yacoub Yousef
- Department of Surgery, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Nabeela Al-Hajaj
- Department of Nuclear Medicine, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Issa Mohamad
- Department of Radiation Oncology, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany
| | - Gerasimos P. Sykiotis
- Department of Endocrinology, Diabetology and Metabolism, Vaud University Hospital Center (CHUV), Lausanne, Switzerland
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Zhu CL, Peng LZ. Clinical analysis of multiple primary gastrointestinal malignant tumors: A 10-year case review of a single-center. World J Gastrointest Oncol 2024; 16:1204-1212. [PMID: 38660651 PMCID: PMC11037063 DOI: 10.4251/wjgo.v16.i4.1204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 02/02/2024] [Accepted: 03/06/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Multiple primary malignant tumors (MPMTs) was first described by Billroth as early as 1889, with the first report published by Warren and Gates in 1932. Since then, numerous cases have been reported. A literature review of 1104269 patients with cancer revealed that the incidence of MPMTs ranged from 0.73 to 11.7%. In recent years, however, there has been a significant upward trend in the incidence of this phenomenon, which may be associated with many different factors, including the advancement of modern diagnostic procedures facilitating the examination and diagnosis of more MPMTs, increased exposure to chemotherapy and radiotherapy that exacerbate the risk of new malignant tumors in patients with cancer, and prolonged survival of patients with cancer allowing sufficient time for the development of new primary cancers. AIM To analyze the incidence, clinical features, treatment factors, prevalence, and prognosis of patients with MPMTs in the gastrointestinal tract treated in a single center. Additionally, we analyzed the different tumor combinations, time interval between the occurrence of tumors, and staging. METHODS This retrospective cohort study analyzed 8059 patients with pathologically confirmed gastrointestinal malignant tumors treated at the Gansu Province Hospital in Lanzhou, Gansu, China between June 2011 and June 2020. Of these, 85 patients had MPMTs. The clinical features, treatment factors, prevalence, and prognosis of this latter cohort were analyzed. RESULTS The incidence of MPMTs in patients with gastrointestinal malignant tumors was 1.05% (85/8059), including 83 double primary malignant tumors and two triple primary malignant tumors of which 57 (67.06%) were synchronous MPMTs (SMPMTs) and 28 (32.94%) were metachronous MPMTs (MMPMTs). The most frequent associations were found between the rectum colon cancers within the SMPMT category and the gastric-colon cancers within the MMPMT category. For the MMPMTs, the median interval was 53 months. The overall 1-, 3- and 5-year survival rates from diagnosis of the first primary cancer were 91.36%, 65.41%, and 45.97%, respectively; those from diagnosis of the second primary cancer were 67.90%, 29.90%, and 17.37%, respectively. CONCLUSION MPMTs in the gastrointestinal tract have a high incidence and poor prognosis. Thus, it is necessary to perform both gastroscopy and colonoscopy in patients with gastrointestinal tumors. Multidisciplinary comprehensive diagnosis and treatment may improve the diagnosis rate and treatment efficiency of MPMTs.
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Affiliation(s)
- Cheng-Lou Zhu
- The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, Gansu Province, China
- Department of Surgical Oncology, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
| | - Ling-Zhi Peng
- The First School of Clinical Medicine, Lanzhou University, Lanzhou 730000, Gansu Province, China
- Department of Surgical Oncology, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
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Wang H, Chen Y, Wang X, Huang B, Xie J, Yin H, Yang J, Wu J, Yuan J, Zhang J. Germline Mutations of Holliday Junction Resolvase Genes in Multiple Primary Malignancies Involving Lung Cancer Lead to PARP Inhibitor Sensitization. Clin Cancer Res 2024; 30:1607-1618. [PMID: 38349998 DOI: 10.1158/1078-0432.ccr-22-3300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 04/14/2023] [Accepted: 02/09/2024] [Indexed: 02/15/2024]
Abstract
PURPOSE The incidence of multiple primary malignancies (MPM) involving lung cancer has increased in recent decades. There is an urgent need to clarify the genetic profile of such patients and explore more efficacious therapy for them. EXPERIMENTAL DESIGN Peripheral blood samples from MPM involving patients with lung cancer were assessed by whole-exome sequencing (WES), and the identified variants were referenced for pathogenicity using the public available database. Pathway enrichment analysis of mutated genes was performed to identify the most relevant pathway. Next, the effects of mutations in relevant pathway on function and response to targeted drugs were verified by in vitro and in vivo experiments. RESULTS Germline exomes of 71 patients diagnosed with MPM involving lung cancer were sequenced. Pathway enrichment analysis shows that the homologous recombination repair (HRR) pathway has the strongest correlation. Moreover, HRR genes, especially key Holliday junction resolvases (HJR) genes (GEN1, BLM, SXL4, and RMI1), were most frequently mutated, unlike the status in the samples from patients with lung cancer only. Next, we identified a total of seven mutations in HJR genes led to homologous recombination DNA repair deficiency and rendered lung cancer cells sensitive to PARP inhibitor treatment, both in vitro and in vivo. CONCLUSIONS This is the first study to map the profile of germline mutations in patients with MPM involving lung cancer. This study may shed light on early prevention and novel targeted therapies for MPM involving patients with lung cancer with HJR mutations.
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Affiliation(s)
- Haoran Wang
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Changzheng Hospital, The Second Military Medical University, Shanghai, China
- Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Yuping Chen
- Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
- Department of Biochemistry and Molecular Biology, Tongji University School of Medicine, Shanghai, China
| | - Xinshu Wang
- Department of Biochemistry and Molecular Biology, Tongji University School of Medicine, Shanghai, China
| | - Binhao Huang
- Department of Gastric Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Juntao Xie
- Department of Surgery, Shanghai Putuo District People's Hospital, Shanghai, China
| | - Hui Yin
- Department of Thoracic Surgery, The First Affiliated Hospital of Shaoyang University, Shaoyang, China
| | - Jie Yang
- State Key Laboratory of Cardiology and Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jinhuan Wu
- Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
- Department of Biochemistry and Molecular Biology, Tongji University School of Medicine, Shanghai, China
| | - Jian Yuan
- Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
- State Key Laboratory of Cardiology and Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jie Zhang
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Kim SH, Baek YB, Park SI. Canine multiple primary tumours: Mammary tubular carcinoma, uterine leiomyosarcoma, and facial sebaceous epithelioma. VET MED-CZECH 2024; 69:94-98. [PMID: 38623156 PMCID: PMC11016304 DOI: 10.17221/103/2023-vetmed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 02/14/2024] [Indexed: 04/17/2024] Open
Abstract
Multiple primary malignant tumours (MPMTs) are multiple neoplasms with independent pathogenetic origins, placing great importance on the tumorigenesis and clinical treatment. However, due to the rare occurrence and diagnostic confusion, MPMTs have rarely been investigated in veterinary medicine. In this report, a 10-year-old intact female Maltese dog had MPMTs, consisting of two malignant tumours and one benign tumour each derived from a topographically different site: tubular carcinoma in the mammary glands, leiomyosarcoma in the uterus and sebaceous epithelioma in the cheek. The unique combination of MPMTs would be the first case in veterinary research to give insight into the diagnosis, disease characteristics, and surgical treatment.
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Affiliation(s)
- Seung-Hyun Kim
- Laboratory of Veterinary Surgery, College of Veterinary Medicine, Chonnam National University, Gwangju, Republic of Korea
| | - Yeong-Bin Baek
- Laboratory of Veterinary Pathology, College of Veterinary Medicine, Chonnam National University, Gwangju, Republic of Korea
| | - Sang-Ik Park
- Laboratory of Veterinary Pathology, College of Veterinary Medicine, Chonnam National University, Gwangju, Republic of Korea; College of Veterinary Medicine and BK21 FOUR Program, Chonnam National University, Gwangju, Republic of Korea
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Khessairi N, Mallek I, Laabidi T, Lahmar A, Bacha D, Slama SB. Synchronous presentation of hepatocellular carcinoma and intrahepatic cholangiocarcinoma: Report of an exceptional case with review of the literature. Int J Surg Case Rep 2024; 114:109140. [PMID: 38113560 PMCID: PMC10767223 DOI: 10.1016/j.ijscr.2023.109140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/21/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE The occurrence of distinct synchronous hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (CC) is extremely rare. Less than 50 cases have been reported in the literature. The aim of our study was to describe the clinicopathological features of this association. CASE PRESENTATION A 75-year-old female patient with chronic hepatitis C cirrhosis presented with three hepatic nodules affecting segments IV, VIII and V during follow-up of her disease. Only the V-segment nodule was radiologically suspicious of malignancy (classified as LI-RADS5). These nodules were resected after discussion of the case in a multidisciplinary meeting. Histological examination showed that the nodules in segments VIII and V corresponded respectively to an HCC with immunohistochemistry showing HepPar1 (+), CK7(-) and CK19(-), and to an intrahepatic CC with immunohistochemistry showing HepPar1 (-), CK7(+) and CK19(+). The excision was radical. The post-operative course was uncomplicated. After a 6-month follow-up, the patient did not develop any locoregional recurrence or metastases. CLINICAL DISCUSSION Synchronous association of HCC and CC is very uncommon, and diagnosis is based on pathological and immunohistochemical examination. Infection with the HCV represents a major risk factor for simultaneous association. Synchronous presentation in HCV-infected individuals has been associated with a poorer prognosis compared with cases where only a single type of liver cancer is present. CONCLUSION The prognosis of this association is generally poor, notably due to the aggressive behavior of CC. Surgical resection remains the first-line treatment option, when possible, but comprehensive management of these complex cases requires a multidisciplinary approach tailored to each patient's specific circumstances.
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Affiliation(s)
- Nayssem Khessairi
- Department of Pathology, M. Slim University Hospital Center, Tunisia.
| | - Inès Mallek
- Department of Pathology, M. Slim University Hospital Center, Tunisia
| | - Taher Laabidi
- Department of Surgery, M. Slim University Hospital Center, Tunisia
| | - Ahlem Lahmar
- Department of Pathology, M. Slim University Hospital Center, Tunisia; University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Dhouha Bacha
- Department of Pathology, M. Slim University Hospital Center, Tunisia; University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Sana Ben Slama
- Department of Pathology, M. Slim University Hospital Center, Tunisia; University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
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11
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Lu M, Zhang X, Chu Q, Chen Y, Zhang P. Susceptibility Genes Associated with Multiple Primary Cancers. Cancers (Basel) 2023; 15:5788. [PMID: 38136334 PMCID: PMC10741435 DOI: 10.3390/cancers15245788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
With advancements in treatment and screening techniques, we have been witnessing an era where more cancer survivors harbor multiple primary cancers (MPCs), affecting approximately one in six patients. Identifying MPCs is crucial for tumor staging and subsequent treatment choices. However, the current clinicopathological criteria for clinical application are limited and insufficient, making it challenging to differentiate them from recurrences or metastases. The emergence of next-generation sequencing (NGS) technology has provided a genetic perspective for defining multiple primary cancers. Researchers have found that, when considering multiple tumor pairs, it is crucial not only to examine well-known essential mutations like MLH1/MSH2, EGFR, PTEN, BRCA1/2, CHEK2, and TP53 mutations but also to explore certain pleiotropic loci. Moreover, specific deleterious mutations may serve as regulatory factors in second cancer development following treatment. This review aims to discuss these susceptibility genes and provide an explanation of their functions based on the signaling pathway background. Additionally, the association network between genetic signatures and different tumor pairs will be summarized.
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Affiliation(s)
| | | | | | | | - Peng Zhang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; (M.L.)
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12
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Sancheti S, Goel AK, Singla A, Chauhan KS, Arora K, Chaudhary D, Dora T, Tahlan S, Kadam P, Joshi P, Sali A, Brar RS, Budukh A, Gulia A, Divatia JV, Badwe R. Deciphering the Patterns of Dual Primary Cases Registered at the Hospital-Based Cancer Registry: First Experience from Rural Cancer Center in North India. J Lab Physicians 2023; 15:524-532. [PMID: 37780887 PMCID: PMC10539055 DOI: 10.1055/s-0043-1768631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/13/2023] [Indexed: 10/03/2023] Open
Abstract
Objectives The objective is to present the patterns of dual primary malignancies diagnosed at the Pathology Laboratory of Cancer Hospital with the support from hospital-based cancer registry (HBCR), Sangrur, Punjab, India for the years 2018 and 2019. Methods HBCR abstracts data from electronic medical records. Trained cancer registry staff abstracts cases in standard pro forma. Dual primary was coded as per the International Agency for Research on Cancer rule and was rechecked by the pathologist. Statistical Analysis Data about multiple primary was entered and documented in an Excel sheet. Time interval was calculated by subtracting the date of diagnosis for second primary and first primary. Results A total of 6,933 cases were registered, 45 cases are dual primary (26 females, 19 males) of which 64.4% are synchronous and 35.6% metachronous cases. Seventy-nine percent received cancer-directed treatment for synchronous and 87% for metachronous. The most common sites of the primary tumor were breast (33%), head and neck (22.2%), gynecological sites (11%), prostate (9%), esophagus (4%), and remaining other tumors (20.8%). Most common sites for second malignancies were gastrointestinal (GI) tract (31%), gynecological sites (18%), head and neck (16%), hematological malignancies (7%), soft tissue sarcoma (4%), breast (2%), and other sites (22%). Conclusion More than 70% of cases of primary tumors were in breast, head and neck, gynecological, and prostate. Of these, more than 60% of the second malignancy was found in the GI tract, gynecological, and head and neck sites. Around two-thirds of dual tumors are synchronous. Breast cancer cases have higher incidence of second malignancy. Regular follow-up is necessary to assess the survival of the second primary.
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Affiliation(s)
- Sankalp Sancheti
- Department of Pathology, Homi Bhabha Cancer Hospital (Unit of Tata Memorial Centre), Sangrur, Punjab, India
| | - Alok Kumar Goel
- Department of Medical Oncology, Homi Bhabha Cancer Hospital (Unit of Tata Memorial Centre), Sangrur, Punjab, India
| | - Anshul Singla
- Department of Surgical Oncology, Homi Bhabha Cancer Hospital (Unit of Tata Memorial Centre), Sangrur, Punjab, India
| | - Kuldeep Singh Chauhan
- Hospital-Based Cancer Registry, Homi Bhabha Cancer Hospital (Unit of Tata Memorial Centre), Sangrur, Punjab, India
| | - Kiran Arora
- Hospital-Based Cancer Registry, Homi Bhabha Cancer Hospital (Unit of Tata Memorial Centre), Sangrur, Punjab, India
| | - Debashish Chaudhary
- Department of Surgical Oncology, Homi Bhabha Cancer Hospital (Unit of Tata Memorial Centre), Sangrur, Punjab, India
| | - Tapas Dora
- Department of Radiation Oncology, Homi Bhabha Cancer Hospital, Sangrur, Punjab, India
| | - Shweta Tahlan
- Department of Surgical Oncology, Homi Bhabha Cancer Hospital (Unit of Tata Memorial Centre), Sangrur, Punjab, India
| | - Prithviraj Kadam
- Division of Medical Records and Cancer Registries, Centre for Cancer Epidemiology, ACTREC, Navi Mumbai, Maharashtra, India
| | - Prachi Joshi
- Division of Medical Records and Cancer Registries, Centre for Cancer Epidemiology, ACTREC, Navi Mumbai, Maharashtra, India
| | - Akash Sali
- Department of Pathology, Homi Bhabha Cancer Hospital (Unit of Tata Memorial Centre), Sangrur, Punjab, India
| | - Rahatdeep Singh Brar
- Department of Radiodiagnosis, Homi Bhabha Cancer Hospital (Unit of Tata Memorial Centre), Sangrur, Punjab, India
| | - Atul Budukh
- Division of Medical Records and Cancer Registries, Centre for Cancer Epidemiology, ACTREC, Navi Mumbai, Maharashtra, India
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India
| | - Ashish Gulia
- Department of Surgical Oncology, Homi Bhabha Cancer Hospital (Unit of Tata Memorial Centre), Sangrur, Punjab, India
| | - Jigeeshu Vasishtha Divatia
- Department of Anaesthesia Critical Care and Pain Management, Homi Bhabha Cancer Hospital (Unit of Tata Memorial Centre), Sangrur, Punjab, India
| | - Rajendra Badwe
- Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
- Homi Bhabha National Institute, Training School Complex, Anushakti Nagar, Mumbai 400094, India
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13
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Perry KW, Yankelevich G, Ashton L, Diorio G. Triple Synchronous Urogenital Malignancies of the Bladder, Kidney, and Prostate: Management in a Single Operation. Cureus 2023; 15:e47107. [PMID: 38021718 PMCID: PMC10646853 DOI: 10.7759/cureus.47107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 10/15/2023] [Indexed: 12/01/2023] Open
Abstract
Synchronous occurrence of three primary malignancies is a rare occurrence, and treatment options are often a difficult undertaking. We present a case of a 57-year-old Hispanic male with synchronous urothelial cell carcinoma of the bladder, renal cell carcinoma, and prostate adenocarcinoma. We elected to manage this patient with a single operation. To our knowledge, this is only the second time a reported operation has been performed of this nature, which includes 21 case reports of triple primary genitourinary tumors, 15 of which are reported as synchronous.
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Affiliation(s)
- Kyler W Perry
- Urology, Medical University of South Carolina, Charleston, USA
| | | | - Leah Ashton
- Urology, Medical University of South Carolina, Charleston, USA
| | - Gregory Diorio
- Urology, Medical University of South Carolina, Charleston, USA
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14
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Tian Y, Liang Y, Yang X. Successful delivery after in vitro fertilization-embryo transfer in a woman with metachronous primary cancer of ovary and endometrium: a case report. BMC Pregnancy Childbirth 2023; 23:677. [PMID: 37726657 PMCID: PMC10507849 DOI: 10.1186/s12884-023-05973-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/04/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND The appearance of malignancies at various times in the same individual, excluding metastases of the initial primary cancer, is termed multiple primary cancers. Double primary gynecological cancers cause inevitable damage to female reproductive function, and the preservation of fertility in such patients remains a challenging issue as relatively few cases have been reported. This case report provides management options for dual primary ovarian and endometrial cancers, including the choice of ovulation induction protocols, considerations during pregnancy and parturition, with the aim of providing assistance to clinicians. CASE PRESENTATION We report a case of a 39-year-old woman with primary infertility and a medical history of right-sided ovarian mucinous borderline tumor with intraepithelial carcinoma, left-sided ovarian mucinous cystadenoma and endometrial cancer, who successfully conceived with in vitro fertilization-embryo transfer (IVF-ET) after three different ovulation induction protocols. During her pregnancy, she was complicated by central placenta praevia with placental implantation and eventually delivered a healthy female infant by caesarean section at 33 gestational weeks. CONCLUSIONS For patients with double primary gynecological cancers who have an intense desire for fertility, the most appropriate oncological treatment should be applied according to the patient's individual situation, and fertility preservation should be performed promptly. Ovulation induction protocol should be individualized and deliberate, with the aim of ensuring that the patient's hormone levels do not precipitate a recurrence of the primary disease during induction of ovulation and maximizing fertility outcomes. In addition, the risk of postpartum hemorrhage due to placental factors cannot be neglected in such patients.
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Affiliation(s)
- Yichang Tian
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Yu Liang
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
- Beijing Maternal and Child Health Care Hospital, Beijing, China.
| | - Xiaokui Yang
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
- Beijing Maternal and Child Health Care Hospital, Beijing, China.
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15
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Komatsu H, Izumi N, Tsukioka T, Inoue H, Ito R, Suzuki S, Nishiyama N. Restrictive Ventilatory Impairment as a Poor Prognostic Factor in Patients Who Undergo Surgical Resection for Metachronous Second Primary Lung Cancer. Ann Thorac Cardiovasc Surg 2023; 29:185-191. [PMID: 36740271 PMCID: PMC10466115 DOI: 10.5761/atcs.oa.22-00182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/09/2023] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To evaluate the prognostic impact of restrictive ventilatory impairment in patients who undergo pulmonary resection of metachronous second primary lung cancer. METHODS The clinical characteristics and surgical outcomes of 70 patients with metachronous second primary lung cancer were analyzed. RESULTS The surgical procedures consisted of wedge resection in 40 patients, segmentectomy in 17, lobectomy in 12, and completion pneumonectomy in one. Patients who underwent ipsilateral pulmonary resection developed more perioperative complications (p = 0.0339). Three-year and 5-year overall survival rates were 78.2% and 69.2%, respectively. In univariate analysis, sex, restrictive ventilatory impairment, and histology of second primary lung cancer were significantly poor prognostic factors (all p <0.05). Multivariate analysis identified restrictive ventilatory impairment to be an independent predictor of a poor prognosis (p = 0.0193). In the 22 patients who died, the cause of death was lung cancer in 11 and other diseases, including pneumonia and respiratory failure, in 11. Death from another disease was significantly more common in patients with restrictive ventilatory impairment (p = 0.0216). CONCLUSION Restrictive ventilatory impairment was an independent predictor of a poor prognosis in patients with a second primary lung cancer. Restrictive ventilatory impairment as a result of repeated thoracic surgery may increase the likelihood of death from another disease.
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Affiliation(s)
- Hiroaki Komatsu
- Department of Thoracic Surgery, Osaka Metropolitan University Hospital, Osaka, Osaka, Japan
| | - Nobuhiro Izumi
- Department of Thoracic Surgery, Osaka Metropolitan University Hospital, Osaka, Osaka, Japan
| | - Takuma Tsukioka
- Department of Thoracic Surgery, Osaka Metropolitan University Hospital, Osaka, Osaka, Japan
| | - Hidetoshi Inoue
- Department of Thoracic Surgery, Osaka Metropolitan University Hospital, Osaka, Osaka, Japan
| | - Ryuichi Ito
- Department of Thoracic Surgery, Osaka Metropolitan University Hospital, Osaka, Osaka, Japan
| | - Satoshi Suzuki
- Department of Thoracic Surgery, Osaka Metropolitan University Hospital, Osaka, Osaka, Japan
| | - Noritoshi Nishiyama
- Department of Thoracic Surgery, Osaka Metropolitan University Hospital, Osaka, Osaka, Japan
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16
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Chen Q, Huang B, Anderson AM, Durbin EB, Arnold SM, Kolesar JM. Association of first primary cancer with risk of subsequent primary cancer among survivors of adult-onset cancers in Kentucky and Appalachian Kentucky. Front Oncol 2023; 13:1193487. [PMID: 37664066 PMCID: PMC10470616 DOI: 10.3389/fonc.2023.1193487] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/31/2023] [Indexed: 09/05/2023] Open
Abstract
Background Appalachia is a region with significant cancer disparities in incidence and mortality compared to Kentucky and the United States. However, the contribution of these cancer health disparities to subsequent primary cancers (SPCs) among survivors of adult-onset cancers is limited. This study aimed to quantify the overall and cancer type-specific risks of SPCs among adult-onset cancer survivors by first primary cancer (FPC) types, residence and sex. Methods This retrospective cohort study from the Kentucky Cancer Registry included 148,509 individuals aged 20-84 years diagnosed with FPCs from 2000-2014 (followed until December 31, 2019) and survived at least 5 years. Expected numbers of SPC were derived from incidence rates in the Kentucky population; standardized incidence ratio (SIR) compared with those expected in the general Kentucky population. Results Among 148,509 survivors (50.2% women, 27.9% Appalachian), 17,970 SPC cases occurred during 829,530 person-years of follow-up (mean, 5.6 years). Among men, the overall risk of developing any SPCs was statistically significantly higher for 20 of the 30 FPC types, as compared with risks in the general population. Among women, the overall risk of developing any SPCs was statistically significantly higher for 20 of the 31 FPC types, as compared to the general population. The highest overall SIR were estimated among oral cancer survivors (SIR, 2.14 [95% CI, 1.97-2.33] among men, and among laryngeal cancer survivors (SIR, 3.62 [95% CI, 2.93-4.42], among women. Appalachian survivors had significantly increased risk of overall SPC and different site specific SPC when compared to non-Appalachian survivors. The highest overall SIR were estimated among laryngeal cancer survivors for both Appalachian and non-Appalachian residents (SIR, 2.50: 95%CI, 2.10-2.95; SIR, 2.02: 95% CI, 1.77-2.03, respectively). Conclusion Among adult-onset cancer survivors in Kentucky, several FPC types were significantly associated with greater risk of developing an SPC, compared with the general population. Risk for Appalachian survivors was even higher when compared to non-Appalachian residents, but was not explained by higher risk of smoking related cancers. Cancers associated with smoking comprised substantial proportions of overall SPC incidence among all survivors and highlight the importance of ongoing surveillance and efforts to prevent new cancers among survivors.
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Affiliation(s)
- Quan Chen
- Markey Cancer Center, University of Kentucky, Lexington, KY, United States
- Division of Cancer Biostatistics, University of Kentucky, Lexington, KY, United States
| | - Bin Huang
- Markey Cancer Center, University of Kentucky, Lexington, KY, United States
- Division of Cancer Biostatistics, University of Kentucky, Lexington, KY, United States
| | | | - Eric B. Durbin
- Markey Cancer Center, University of Kentucky, Lexington, KY, United States
- Department of Radiology, University of Kentucky, Lexington, KY, United States
| | - Susanne M. Arnold
- Markey Cancer Center, University of Kentucky, Lexington, KY, United States
- Department of Internal Medicine, University of Kentucky, Lexington, KY, United States
| | - Jill M. Kolesar
- Markey Cancer Center, University of Kentucky, Lexington, KY, United States
- Department of Obstetrics and Gynecology, University of Kentucky, Lexington, KY, United States
- Department of Pharmacy Practice and Science, University of Kentucky, Lexington, KY, United States
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17
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Mei L, Feng J, Zhao L, Zheng X, Li X. Nomogram for predicting survival of patients with gastric cancer and multiple primary malignancies: a real-world retrospective analysis using the Surveillance, Epidemiology and End Results database. J Int Med Res 2023; 51:3000605231187944. [PMID: 37572023 PMCID: PMC10423457 DOI: 10.1177/03000605231187944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/12/2023] [Indexed: 08/14/2023] Open
Abstract
OBJECTIVES Gastric cancer combined with multiple primary malignancies (GCM) is increasingly common. This study investigated GCM clinical features and survival time. METHODS Patients with GCM and GC only (GCO) were selected from the Surveillance, Epidemiology and End Results (SEER) database. Survival was compared between GCM and GCO groups using propensity score matching. Then, the GCM group was divided into a training cohort and a validation cohort. These cohorts were used to establish a nomogram for survival prediction in patients with GCM. RESULTS Survival time was significantly longer in the GCM group than in the GCO group. All-subsets regression was used to identify four variables for nomogram establishment: age, gastric cancer sequence, N stage, and surgery. The concordance index and time-dependent receiver operating characteristic curve indicated that the nomogram had favorable discriminative ability. Calibration plots of predicted and actual probabilities showed good consistency in both the training and validation cohorts. Decision curve analysis and risk stratification showed that the nomogram was clinically useful; it had favorable discriminative ability to recognize patients with different levels of risk. CONCLUSIONS Compared with GCO, GCM is a relatively indolent malignancy. The nomogram developed in this study can help clinicians to assess GCM prognosis.
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Affiliation(s)
- Linhang Mei
- Department of Surgical Oncology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China
| | - Jie Feng
- Department of Traumatic Orthopedics, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China
| | - Lingdan Zhao
- Department of General Practice, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China
| | - Xiaokang Zheng
- Emergency Department, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China
| | - Xiao Li
- Department of General Surgery, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China
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18
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Chen N, Shi L, Ge J, Jia R, Jiang J. Risk and prediction of multiple primary malignancies after early gastric cancer. Front Oncol 2023; 13:1205358. [PMID: 37560468 PMCID: PMC10409482 DOI: 10.3389/fonc.2023.1205358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/10/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Patients with early gastric cancer have increased risk of developing multiple primary malignancies (MPM) due to improved survival rates. The purpose of this study was to evaluate the clinicopathological features of MPM and to generate a useful tool for predicting the development of MPM after early gastric cancer. METHODS We selected 1025 early gastric cancer patients with complete medical records for a retrospective analysis. The Cox proportional risk regression model was used to analyze the independent risk factors for the development of MPM in early gastric cancer. RStudio software was used to compare the OS of early gastric cancer patients with and without MPM, and a nomogram was established to predict the probability of MPM 1-, 2-, 3-year after early gastric cancer. The predictive effectiveness of the nomogram was evaluated by the C-index and calibration curve. Decision curve analysis (DCA) measured the applicability of the nomogram to clinical practice. RESULTS Of the 1025 patients with early gastric cancer, 66 patients (6.4%) had 69 primary cancers other than early gastric cancer. They had a median follow-up of 41 months, and their cumulative incidence of MPM was 4.9%, 5.4% and 5.9% after 1-, 2-, and 3- year, respectively. Oesophageal cancer was the most frequently detected MPM, followed by lung and colorectal cancers. Male (p=0.038), age ≥65 years (p=0.003), smoking history (p=0.036), and lymph node metastasis (p=0.013) were independent risk factors for MPM in patients with early gastric cancer. Patients with early gastric cancer with MPM had a worse OS prognosis than patients with early gastric cancer without MPM (p<0.001). The internally validated nomogram predicted the probability of developing MPM after early gastric cancer (C index= 0.697). The calibration chart showed that the predicted probability of MPM in early gastric cancer was similar to the observed result, and the DCA showed strong clinical practicability. CONCLUSION After the diagnosis and treatment of early gastric cancer, we should be alert to the possibility of MPM and perform regular and careful monitoring.
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Affiliation(s)
| | | | | | | | - Junmei Jiang
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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19
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Merhaben S, Mohamed AB, Khsiba A, Mahmoudi M, Nechi S, Chelbi E, Kilani H, Yakoubi M, Hamzaoui ML, Medhioub M, Azouz MM. Synchronous primary gastric and renal tumors: a case report. Future Sci OA 2023; 9:FSO865. [PMID: 37228858 PMCID: PMC10203905 DOI: 10.2144/fsoa-2023-0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/02/2023] [Indexed: 05/27/2023] Open
Abstract
Synchronous multiple primary cancers of the stomach and kidney are very rare, only 45 cases of synchronous multiple primary cancers of the stomach and kidney had been reported in the literature up until 2020. Thus far, no particular risk factors have been identified. We present a case of synchronous multiple primary cancers of the stomach and kidney in a 67-year-old female presenting with a 3-month history of vomiting and abdominal pain. The diagnosis of gastric adenocarcinoma with signet ring cells was confirmed through upper endoscopy with biopsies, while CT-guided biopsies of the renal tumor confirmed the diagnosis of primary kidney neoplasm.
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Affiliation(s)
- Salma Merhaben
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia
| | - Asma Ben Mohamed
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia
| | - Amal Khsiba
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia
| | - Moufida Mahmoudi
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia
| | - Salwa Nechi
- Histopathology Department, Mohamed Taher Maamouri Hospital,Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia
| | - Emna Chelbi
- Histopathology Department, Mohamed Taher Maamouri Hospital,Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia
| | - Houda Kilani
- Histopathology Department, Mohamed Taher Maamouri Hospital,Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia
| | - Manel Yakoubi
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia
| | - Mohamed Lamine Hamzaoui
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia
| | - Mouna Medhioub
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia
| | - Mohamed Moussadak Azouz
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia
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Taj S, Hussain A, Sanekommu H, Miller B, Austin C, Kilada C, Dandu S, Ahsan E, Erler BS. Metachronous Squamous Cell Carcinoma of the Esophagus After Resolution of Previous Adenocarcinoma. ACG Case Rep J 2023; 10:e01097. [PMID: 37434661 PMCID: PMC10332822 DOI: 10.14309/crj.0000000000001097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/08/2023] [Indexed: 07/13/2023] Open
Abstract
Esophageal cancer is the sixth leading cause of cancer-related death worldwide. Metachronous malignancies refer to multiple independent primary cancers diagnosed at least 6 months apart. The incidence of metachronous esophageal cancers with different histologic subtypes is extremely rare. This case presents an unprecedented occurrence of esophageal adenocarcinoma, followed by metachronous squamous cell carcinoma.
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Affiliation(s)
- Sobaan Taj
- Jersey Shore University Medical Center, Department of Medicine, Neptune City, NJ
| | | | | | - Brett Miller
- Jersey Shore University Medical Center, Department of Medicine, Neptune City, NJ
| | | | | | - Sowmya Dandu
- Jersey Shore University Medical Center, Department of Medicine, Neptune City, NJ
| | - Eram Ahsan
- Jersey Shore University Medical Center, Department of Medicine, Neptune City, NJ
| | - Brian S. Erler
- Jersey Shore University Medical Center, Department of Pathology, Neptune City, NJ
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21
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Andreika L, Vankevičienė K, Plioplytė M, Bitinaitytė M, Rudaitis V. Multiple Rare Primary Malignancies: A Mixed Squamous Neuroendocrine Adenocarcinoma of the Cervix, Metastasized Carcinosarcoma and Extramammary Vulvar Paget's Disease Case Report. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050995. [PMID: 37241226 DOI: 10.3390/medicina59050995] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/16/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023]
Abstract
The occurrence of more than one primary malignant tumor in a single patient is rare. Multiple primary malignancies can pose difficulties in differential diagnosis between primary tumors and metastasis. Here, we present a case report with multiple primary malignancies. The patient is a 45-year-old female who was diagnosed with cervical mixed squamous neuroendocrine adenocarcinoma, metastasized carcinosarcoma and extramammary vulvar Paget's disease. The patient was first diagnosed with a microinvasive squamous cervical carcinoma in situ. After a few months, the amputation of a small residual tumor and histological evaluation revealed an IA1-stage poorly differentiated (G3) mixed squamous and neuroendocrine cervical adenocarcinoma. After two years, the disease had progressed and biopsies from altered sites were taken. Histological diagnosis from an ulcerated vulvar region revealed extramammary vulvar Paget's disease. A biopsy from vagina polyp revealed an earlier diagnosed mixed squamous and neuroendocrine cervical adenocarcinoma. However, histological diagnosis from an inguinal lymph node biopsy was unexpected and revealed carcinosarcoma. It indicated either the development of another primary malignancy, or an unusual spread of metastasis. Clinical presentation as well as diagnostic and treatment challenges are discussed in this case report. This case report shows that multiple primary malignancy cases are difficult to manage both for clinicians and the patient because the therapeutic options can become limited. This complex case was managed by a multidisciplinary team.
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Affiliation(s)
- Linas Andreika
- Clinic of Obstetrics and Gynaecology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Čiurlionio Str. 21/27, LT-03101 Vilnius, Lithuania
| | - Karolina Vankevičienė
- Faculty of Medicine, Vilnius University, M. K. Čiurlionio Str. 21/27, LT-03101 Vilnius, Lithuania
| | - Marija Plioplytė
- Faculty of Medicine, Lithuanian University of Health Sciences, A.Mickevičiaus Str. 9, LT-44307 Kaunas, Lithuania
| | - Monika Bitinaitytė
- Faculty of Medicine, Lithuanian University of Health Sciences, A.Mickevičiaus Str. 9, LT-44307 Kaunas, Lithuania
| | - Vilius Rudaitis
- Clinic of Obstetrics and Gynaecology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Čiurlionio Str. 21/27, LT-03101 Vilnius, Lithuania
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Zhan Z, Guo W, Li J, Wan X, Guo J, Bai O. Clinical features and prognosis of double primary malignant neoplasms in patients with non-hodgkin lymphoma. Discov Oncol 2023; 14:54. [PMID: 37133771 PMCID: PMC10156874 DOI: 10.1007/s12672-023-00667-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/23/2023] [Indexed: 05/04/2023] Open
Abstract
To investigate the clinical features, survival, and prognostic factors of patients with double primary malignant neoplasms (DPMNs) comprising non-Hodgkin lymphoma (NHL) and malignant solid tumors. Of the 2352 patients diagnosed with NHL, 105 (4.46%) patients were diagnosed with DPMNs, 42 (40.0%) had NHL first (the NHL-first group) and 63 (60.0%) had solid tumor first (the ST-first group). Females were more frequent in the ST-first group, and the interval time between the two tumors was longer. More NHLs in early stages and originating from extranodal sites were observed in the NHL-first group. Male, age ≥ 55 years at diagnosis of the first tumor, interval time <60 months, NHL diagnosed first, NHL arising from an extranodal site, DPMNs without breast cancer, and no surgery for the first primary tumor were associated with poorer overall survival (OS). Interval time <60 months and NHL diagnosed first were independent risk factors that affected the prognosis of patients with DPMNs. Therefore, careful monitoring and follow-up are especially important for these patients. 50.5% (53/105) of patients with DPMNs did not receive chemotherapy or radiotherapy prior to the diagnosis of the second tumor. We further compared the baseline characteristics of diffuse large B-cell lymphoma(DLBCL) patients with and without solid tumors, the former had a higher proportion of extranodal DLBCL, suggesting that extranodal DLBCL is more likely to develop solid tumors than nodal DLBCL.
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Affiliation(s)
- Zhumei Zhan
- Department of Hematology, The First Hospital of Jilin University, No. 71 Xinmin Street, Chaoyang District, Changchun, Jilin, 130021, China
| | - Wei Guo
- Department of Hematology, The First Hospital of Jilin University, No. 71 Xinmin Street, Chaoyang District, Changchun, Jilin, 130021, China
| | - Jia Li
- Department of Hematology, The First Hospital of Jilin University, No. 71 Xinmin Street, Chaoyang District, Changchun, Jilin, 130021, China
| | - Xin Wan
- Department of Hematology, The First Hospital of Jilin University, No. 71 Xinmin Street, Chaoyang District, Changchun, Jilin, 130021, China
| | - Jing Guo
- Department of Hematology, The First Hospital of Jilin University, No. 71 Xinmin Street, Chaoyang District, Changchun, Jilin, 130021, China
| | - Ou Bai
- Department of Hematology, The First Hospital of Jilin University, No. 71 Xinmin Street, Chaoyang District, Changchun, Jilin, 130021, China.
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Badwelan M, Muaddi H, Ahmed A, Lee KT, Tran SD. Oral Squamous Cell Carcinoma and Concomitant Primary Tumors, What Do We Know? A Review of the Literature. Curr Oncol 2023; 30:3721-3734. [PMID: 37185396 PMCID: PMC10136780 DOI: 10.3390/curroncol30040283] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/21/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023] Open
Abstract
Head and neck cancer is among the top ten cancers worldwide, with most lesions in the oral cavity. Oral squamous cell carcinoma (OSCC) accounts for more than 90% of all oral malignancies and is a significant public health concern. Patients with OSCC are at increased risk for developing concomitant tumors, especially in the oral cavity, due to widely genetically susceptible mucosa to carcinogenic factors. Based on fulfilling specific criteria, these concomitant tumors can be called second primary tumors (SPTs), which can be further categorized into metachronous and synchronous tumors. This research reviews the literature that investigated the concurrent OSCC with second or multiple primaries to improve understanding of the definition, classification guidelines, and its effect on cancer survival. It also highlights the current investigation methods, the variation of standard treatment approaches due to such a phenomenon, and preventive measures discussed in the literature.
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24
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Triple Primary Malignancies: Tumor Associations, Survival, and Clinicopathological Analysis: A 25-Year Single-Institution Experience. Healthcare (Basel) 2023; 11:healthcare11050738. [PMID: 36900742 PMCID: PMC10001057 DOI: 10.3390/healthcare11050738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/18/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
The detection of multiple primary malignancies is on the rise despite their rare occurrence rate. This research aims to determine the prevalence, tumor association patterns, overall survival, and the correlation between survival time and independent factors in patients with triple primary malignancies. This single-center retrospective study included 117 patients with triple primary malignancies admitted to a tertiary cancer center between 1996 and 2021. The observed prevalence was 0.082%. The majority of patients (73%) were over the age of fifty at the first tumor diagnosis, and regardless of gender, the lowest median age occurred in the metachronous group. The most common tumor associations were found between genital-skin-breast, skin-skin-skin, digestive-genital-breast, and genital-breast-lung cancer. The male gender and being over the age of fifty at the first tumor diagnosis are associated with a higher risk of mortality. Compared with the metachronous group, patients with three synchronous tumors demonstrate a risk of mortality 6.5 times higher, whereas patients with one metachronous and two synchronous tumors demonstrate a risk of mortality three times higher. The likelihood of subsequent malignancies should always be considered throughout cancer patients' short- and long-term surveillance to ensure prompt tumor diagnosis and treatment.
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25
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Allahyari A, Maharati A, Jafari-Nozad AM, zangooie A. Prostate cancer, chronic myelogenous leukemia and multiple myeloma in a single patient: a case report and review of the literature. J Med Case Rep 2023; 17:35. [PMID: 36739400 PMCID: PMC9899381 DOI: 10.1186/s13256-023-03753-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/01/2023] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Synchronous or metachronous multiple primary malignancies (MPMs) are a known phenomenon. These occurrences may be spontaneous or related to environmental risk factors or genetic predisposition. Chronic myelogenous leukemia (CML) and Multiple myeloma (MM) are two uncommon hematologic malignancies, arises from two different cell lineage. The coexistence of CML and MM that is a rare phenomenon, with only 29 cases reported in the literature. To the best of our, this combination of triple primary cancers has not been reported in a single patient. CASE PRESENTATION Herein, we reported a case of an 85-year-old Iranian male with three confirmed primary malignant neoplasms. The patient presented with synchronous prostate cancer and CML, in august 2016. He received imatinib and nilotinib for CML and hormonal therapy for prostate cancer. He remained in good control at further follow-ups for about 5 years. In the follow-up period and after 61 months treatment with tyrosine kinase inhibitors (TKIs), CML was undetectable in molecular tests, but the presence of serum M-protein, abnormal plasma cells in the bone marrow, and CRAB criteria was compatible with MM. CONCLUSION We must evaluate the possibility of multiple primary cancers during cancer treatment and follow-up and it may be worthwhile to monitor serum electrophoresis and protein levels in TKIs-treated patients.
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Affiliation(s)
- Abolghasem Allahyari
- grid.411583.a0000 0001 2198 6209Department of Hematology-Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhosein Maharati
- grid.411583.a0000 0001 2198 6209Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Masoud Jafari-Nozad
- grid.411701.20000 0004 0417 4622Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Alireza zangooie
- grid.411701.20000 0004 0417 4622Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran ,grid.411701.20000 0004 0417 4622Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
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Chen J, Zhou Z, Chen W, Khan AA, Liu Z, Wang K, Yang F, Xu X. Hepatocellular carcinoma complicated with huge posterior pancreas head lymph node metastasis and primary renal carcinoma: A case report. Front Oncol 2022; 12:989172. [PMID: 36568158 PMCID: PMC9773375 DOI: 10.3389/fonc.2022.989172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 11/24/2022] [Indexed: 12/13/2022] Open
Abstract
The incidence of hepatocellular carcinoma (HCC) associated with extrahepatic primary malignancy (EHPM) is extremely rare, especially for those that involve primary renal cell carcinoma (PRC). Here we present a case of a 66-year-old male who was diagnosed with HCC complicated with lymph node metastasis at posterior pancreas head and PRC. Biopsy results of the liver and the lymph node confirmed the diagnosis of HCC. The disease progressions of both HCC and PRC are controlled effectively following the initiation of comprehensive therapy including pembrolizumab, lenvatinib, radiotherapy, and transcatheter arterial chemo-embolization (TACE). Ultimately, the patient had successfully access to surgery and complete response (CR) of all the tumors were achieved after surgery.
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Affiliation(s)
- Jun Chen
- The Four School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China,Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China,Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhiyi Zhou
- The Four School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China,Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China,Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wenyan Chen
- Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Abid Ali Khan
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China,Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhikun Liu
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China,Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kai Wang
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China,Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Fan Yang
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China,Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao Xu
- Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China,Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China,*Correspondence: Xiao Xu,
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Luo ZH, Qi WL, Jin AF, Liao FX, Liu Q, Zeng QY. The role of 18F-FDG PET/CT in patients with synchronous multiple primary malignant neoplasms occurring at the same time. Front Oncol 2022; 12:1068055. [DOI: 10.3389/fonc.2022.1068055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/10/2022] [Indexed: 12/04/2022] Open
Abstract
BackgroundSynchronous multiple primary malignant neoplasms occurring at the same time (SMPMNS) are not currently uncommon in clinical oncological practice; however, the diagnostic performance of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for SMPMNS needs further elucidation.PurposeThis study aimed to evaluate the application of 18F-FDG PET/CT in patients with SMPMNS.Materials and methodsThe clinical and imaging data of 37 patients with SMPMNS who had undergone 18F-FDG PET/CT from October 2010 to December 2020 were retrospectively analyzed. The kappa consistency test was applied to evaluate the consistency of the diagnostic performance between PET/CT and conventional imaging (CI). The sensitivity, specificity, and accuracy of PET/CT and CI in the detection of metastatic lesions were compared.ResultsThis retrospective diagnostic study included 74 lesions identified in 37 patients with SMPMNS, with 94.6% of patients having double primary tumors. Of the incidences of SMPMNS, 18.9% occurred in the same organ system, with respiratory tumors being the most common type of neoplasm (43.2%) and the lung being the most common primary site (40.5%). The overall survival of SMPMNS patients without metastases was longer than that of those with metastases (χ2 = 12.627, p = 0.000). The maximum standardized uptake value (SUVmax), the SUVmax ratio (larger SUVmax/smaller SUVmax), and the difference index of SUVmax (DISUVmax) [(larger SUVmax − smaller SUVmax)/larger SUVmax] of the primary lesions ranged from 0.9 to 41.7 (average = 12.3 ± 7.9), from 0.3 to 26.7 (average = 4.4 ± 6.9), and from 0.0% to 96.3% (average = 50.3% ± 29.3%), respectively. With regard to diagnostic accuracy, PET/CT and CI showed poor consistency (κ = 0.096, p = 0.173). For the diagnosis of primary lesions (diagnosed and misdiagnosed), PET/CT and CI also showed poor consistency (κ = 0.277, p = 0.000), but the diagnostic performance of PET/CT was better than that of CI. In the diagnosis of metastases, the patient-based sensitivity, specificity, and accuracy of PET/CT were 100.0%, 81.8%, and 89.2%, respectively, while those of CI were 73.3%, 100.0%, 89.2%, respectively. The sensitivity and specificity values were significantly different, with PET/CT having higher sensitivity (p = 0.02) and CI showing higher specificity (p = 0.02).Conclusions18F-FDG PET/CT improves the diagnostic performance for SMPMNS and is a good imaging modality for patients with SMPMNS.
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El-Badrawy A, Shebel H, El Atta HMA. MDCT diagnosis of synchronous primary gastrointestinal tract carcinoma and other solid malignancies: case series study. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2022. [DOI: 10.1186/s43055-022-00707-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Abstract
Background
The presentation of synchronous multiple primary tumors is rare. The aim of this report was to report an uncommon series of cases diagnosed with synchronous gastrointestinal tract carcinoma and other solid malignancies by multidetector computed tomography.
Case presentation
Our report included 34 patients with synchronous gastrointestinal tract carcinoma and other solid malignancies from November 2009 to September 2019. They were 14 men and 20 women (mean age, 65.5 year; range, 52–82 years). The highest number of GIT cases were colonic carcinomas detected in 70% (24/34) of the patients. The most frequent extra-gastrointestinal primary malignancy sites were renal cell and breast carcinomas, 17.6% (6/34) of each.
Conclusions
Careful preoperative evaluation is recommended to detect this pattern of synchronous extra-gastrointestinal tumors. More reports of such cases should help to clarify the pathogenesis of this phenomenon and may lead to a new treatment strategy for synchronous gastrointestinal malignancy and other solid malignancies.
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El-Badrawy A. Multi-detector computed tomography (MDCT) evaluation of synchronous renal cell carcinoma and other solid malignancies. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2022. [DOI: 10.1186/s43055-022-00748-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Multiple primary malignant neoplasms (MPMNs) became more prevalent as the population aged and medical technology progressed. The purpose of this research was to review the findings of multidetector computed tomography (MDCT) in synchronous renal cell carcinoma and other solid tumors.
Results
31 individuals with synchronous renal cell carcinoma and additional solid cancers were included in this retrospective analysis. CT scanning was carried out using 64 MDCT scanners. All sixty-two malignancies were undergoing pathological assessment. Out of 685 patients with renal cell carcinoma, 31 individuals were identified with another primary solid cancer that occurred concurrently. All of our instances were pathologically verified. In all 31 individuals, clear renal cell carcinoma was found. The most frequent extra-renal malignancies were hepatocellular carcinoma (10/31), followed by breast carcinoma (4/31), non-Hodgkin lymphoma (4/31), bronchogenic carcinoma (3/31), colonic carcinoma (3/31), prostatic carcinoma (2/31), urinary bladder carcinoma (1/31), periampullary carcinoma (1/31), mucoepidermoid carcinoma (1/31) and skin squamous cell carcinoma (1/31) as well as malignant hemangioendothelioma (1/31).
Conclusion
MDCT scanning was an accurate imaging method for diagnosing synchronous renal cell carcinoma and other solid tumors. Even in the face of numerous cancers, the goal of therapy in cancer patients must always be curative. During the pretreatment examination, the potential of synchronous double malignancies with renal cell carcinoma should be explored.
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30
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Truong VT, Al-Shakfa F, Newman N, Roberge D, Masucci GL, Tran TPY, Boubez G, Shedid D, Yuh SJ, Wang Z. Spinal Metastasis in Multiple Primary Malignancies Involving Lung Cancer: Clinical Characteristics and Survival. World Neurosurg 2022; 167:e726-e731. [PMID: 36030008 DOI: 10.1016/j.wneu.2022.08.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The incidence of multiple primary malignancies (MPM) has increased in recent decades. Our aim was to evaluate incidence, clinical features, and survival in cases of spinal metastases from MPM in which one of the malignancies is lung cancer. METHODS We retrospectively reviewed an institutional database of lung cancer patients with spinal metastasis and extracted all cases of MPM. RESULTS Among 275 patients who had spinal metastasis with lung cancer as one of the diagnoses, 21 (7.6%) patients with MPM were identified. Mean patient age was 68.5 years (95% confidence interval [CI], 65.3-71.7). The most common cancers diagnosed in addition to lung cancer were breast cancer (5 patients, 24%), upper aerodigestive tract cancer (4 patients, 19%), and prostate cancer (4 patients, 19%). Eighteen (86%) patients walked independently, and 3 (14%) patients walked with help. Seventeen (80.9%) patients had a good Karnofsky performance scale score. The median survivals from the date of first cancer diagnosis, last cancer diagnosis, and spinal metastasis diagnosis were 109.8 months (95% CI, 23.5-196.1), 17.8 months (95% CI, 5.8-29.8), and 10.3 months (95% CI, 5.4-15.2), respectively. Actual rates of survival at 6 months, 12 months, and 24 months from the date of spinal metastasis diagnosis were 81%, 42.9%, and 23.8%, respectively. CONCLUSIONS The present study is the first series to our knowledge to show that survival of patients with spinal metastasis and MPM involving lung cancer is not clearly inferior to that of patients with spinal metastasis and lung cancer alone.
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Affiliation(s)
- Van Tri Truong
- Division of Orthopedics, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Québec, Canada; Department of Neurosurgery, Vinmec Central Park International Hospital, Vinmec Healthcare System, Ho Chi Minh City, Vietnam.
| | - Fidaa Al-Shakfa
- Division of Orthopedics, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Québec, Canada
| | - Nicholas Newman
- Division of Orthopedics, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Québec, Canada
| | - David Roberge
- Division of Radiation Oncology, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Québec, Canada
| | - Giuseppina Laura Masucci
- Division of Radiation Oncology, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Québec, Canada
| | - Thi Phuoc Yen Tran
- Department of Neurosurgery, Vinmec Central Park International Hospital, Vinmec Healthcare System, Ho Chi Minh City, Vietnam; Research Center, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Québec, Canada
| | - Ghassan Boubez
- Division of Orthopedics, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Québec, Canada
| | - Daniel Shedid
- Division of Neurosurgery, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Québec, Canada
| | - Sung-Joo Yuh
- Division of Neurosurgery, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Québec, Canada
| | - Zhi Wang
- Division of Orthopedics, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Québec, Canada
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Chen J, Zhu MY, Huang YH, Zhou ZC, Shen YY, Zhou Q, Fei MJ, Kong FC. Synchronous primary duodenal papillary adenocarcinoma and gallbladder carcinoma: A case report and review of literature. World J Clin Cases 2022; 10:9790-9797. [PMID: 36186218 PMCID: PMC9516900 DOI: 10.12998/wjcc.v10.i27.9790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/20/2022] [Accepted: 08/17/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Synchronous primary cancers (SPCs) have become increasingly frequent over the past decade. However, the coexistence of duodenal papillary and gallbladder cancers is rare, and such cases have not been previously reported in the English literature. Here, we describe an SPC case with duodenal papilla and gallbladder cancers and its diagnosis and successful management.
CASE SUMMARY A 68-year-old Chinese man was admitted to our hospital with the chief complaint of dyspepsia for the past month. Contrast-enhanced computed tomography of the abdomen performed at the local hospital revealed dilatation of the bile and pancreatic ducts and a space-occupying lesion in the duodenal papilla. Endoscopy revealed a tumor protruding from the duodenal papilla. Pathological findings for the biopsied tissue revealed tubular villous growth with moderate heterogeneous hyperplasia. Surgical treatment was selected. Macroscopic examination of this surgical specimen revealed a 2-cm papillary tumor and another tumor protruding by 0.5 cm in the gallbladder neck duct. Intraoperative rapid pathology identified adenocarcinoma in the gallbladder neck duct and tubular villous adenoma with high-grade intraepithelial neoplasia and local canceration in the duodenal papilla. After an uneventful postoperative recovery, the patient was discharged without complications.
CONCLUSION It is essential for clinicians and pathologists to maintain a high degree of suspicion while evaluating such synchronous cancers.
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Affiliation(s)
- Jing Chen
- Department of General Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
| | - Ming-Yuan Zhu
- Department of General Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
| | - Yan-Hua Huang
- Department of General Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
| | - Zhong-Cheng Zhou
- Department of General Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
| | - Yi-Yu Shen
- Department of General Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
| | - Quan Zhou
- Department of Pathology, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
| | - Ming-Jian Fei
- Department of Pathology, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
| | - Fan-Chuang Kong
- Department of General Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
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Sharma A, Sharma A, Patni S, Gupta A, Ledwani N, Saini S, Patni N, Bapna A, Somani N, Sharma M, Verma S, Sharma GK, Nunia V. A single centre study from western India to evaluate the frequency of developing second and subsequent multiple primary malignancies among cancer survivors. SURGICAL AND EXPERIMENTAL PATHOLOGY 2022. [DOI: 10.1186/s42047-022-00122-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Aim
This study was designed to evaluate the frequency of developing second and subsequent primary cancers among cancer survivors.
Methods
We have retrospectively analyzed 121 multiple primary cancer patients treated at Bhagwan Mahavir Cancer Hospital and Research Centre, Jaipur, Rajasthan, India from the last 20 years. The survival analysis was performed by Kaplan-Meier methodology.
Results
The prevalence of multiple primary malignant tumors (MPMTs) was 1.51% (121/8000), with a male to female ratio of 1:1.42. In males most of the reported MPMTs were synchronous and most common first primary cancer cases were head & neck and lung whereas, in females most of the reported MPMTs were metachronous and most common first primary cancer cases were breast and gynaecological malignancies. Family history was reported in 15 cases. Maximum 33.05% patients received combined treatment of chemotherapy, radiotherapy and 91.73% (111/121) of patients with MPMTs were effectively followed up, 35 (28.92%) patients died and 5-year survival rate of the remaining 86 patients was 68.46%.
Conclusions
In the present observational study the most frequent sites of MPMTs in men were head & neck and lung whereas, in women breast and gynaecological sites were common. Therefore, careful monitoring and follow up are required for these patients.
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Simanjuntak KAT, Al Fauzi A, Christi AY, Budiono PS, Susilo RI, Haq IBI, Suroto NS, Fauziah D, Djatisoesanto W. Clear-cell renal cell carcinoma and glioblastoma multiforme coexistence: Double primary malignancy, does it have a causal relationship? Surg Neurol Int 2022; 13:361. [PMID: 36128116 PMCID: PMC9479614 DOI: 10.25259/sni_598_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 07/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background: Multiple primary malignancies (MPMs), especially coexistence of renal cell carcinoma (RCC) and glioblastoma multiforme (GBM), are rare. The most likely clinical diagnosis in patient with tumor in another organ is metastatic brain tumor. Although GBM is the most common brain tumor, it is rarely coexistent with other malignancies. Case Description: A 64-year-old female presented with headache and dizziness, along with abdominal pain for 2 weeks before being admitted. The abdominal computed tomography (CT) scan showed a kidney tumor. The patient developed left hemiplegia, and the brain CT scan showed an intracranial tumor. The patient suggested for radical nephrectomy and craniotomy tumor removal. Histopathology of the kidney and brain tumor revealed two different features, which showed RCC and GBM. Immunohistochemistry result confirmed the diagnosis of GBM and IDH1 wild type; coexistent with clear cell RCC. Conclusion: The coexistence of carcinoma and glioma should be regarded as coincidental cases if it did not accomplish the criteria for tumor-to-tumor metastasis or proven to be a genetic syndrome. This case report provides an addition to the literature about double primary malignancy in a single patient. More studies are needed to confirm whether they have causal relationship or merely coincidental findings.
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Affiliation(s)
| | - Asra Al Fauzi
- Department of Neurosurgery, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Ayu Yoniko Christi
- Department of Neurosurgery, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Perthdyatama Syifaq Budiono
- Department of Neurosurgery, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Rahadian Indarto Susilo
- Department of Neurosurgery, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Irwan Barlian Immadoel Haq
- Department of Neurosurgery, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Nur Setiawan Suroto
- Department of Neurosurgery, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Dyah Fauziah
- Department of Anatomical Pathology, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Wahjoe Djatisoesanto
- Department of Urology, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
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Wan Y, Wang Z, Yang N, Liu F. Treatment of Multiple Primary Malignancies With PD-1 Inhibitor Camrelizumab: A Case Report and Brief Literature Review. Front Oncol 2022; 12:911961. [PMID: 35865468 PMCID: PMC9294358 DOI: 10.3389/fonc.2022.911961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 06/01/2022] [Indexed: 11/17/2022] Open
Abstract
Background With significant advances in the diagnostic tools and treatment modalities of cancer, the incidence of multiple primary malignancies (MPMs) has increased in the last decades. The therapeutic option changed with the arising of immune checkpoint inhibitors (ICIs), which have improved the survival of a broad spectrum of tumors. However, little information is available when it comes to the efficacy, resistance, and underlying mechanisms of ICIs. Case Presentation A 67-year-old woman was diagnosed with pulmonary sarcomatoid carcinoma (PSC) with a history of hepatocellular carcinoma (HCC) and viral hepatitis B. Following the lack of response to systemic chemotherapy, she was treated with camrelizumab, an anti-programmed cell death protein 1 monoclonal antibody, in combination with chemotherapy, and a partial response was obtained both in PSC and HCC. After a course of 9-month treatment, the PSC lesion shrank still, while HCC was evaluated as a progressive disease with an increase in the diameter of liver neoplasm, elevated alpha-fetoprotein, and enlarged abdominal lymph nodes. Then, with the addition of radiotherapy for abdominal metastasis, the lung lesion was continuously shrinking. In the meantime, the liver neoplasm and abdominal lymph nodes showed no significant enlargement. Conclusion Camrelizumab combination therapy could consistently benefit the MPM patients with PSC and HCC, which may be a promising option for patients with MPMs.
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Affiliation(s)
- Yuchen Wan
- Department of Traditional Chinese Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- The First Faculty of Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhixue Wang
- Department of Traditional Chinese Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Ning Yang
- Department of Radiation Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Fenye Liu
- Department of Traditional Chinese Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- *Correspondence: Fenye Liu,
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Xiao L, Cao T, Ou J, Liang W. Clinical characteristics and prognostic analysis of multiple primary malignant neoplasms in female patients with breast cancer or genitalia malignancies. PeerJ 2022; 10:e13528. [PMID: 35769138 PMCID: PMC9235813 DOI: 10.7717/peerj.13528] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/11/2022] [Indexed: 01/17/2023] Open
Abstract
Background As public awareness of health has increased and diagnostic and treatment options have improved, the survival of patients with malignant tumors has continued to extend, and the population has been aging, the number of multiple primary malignant neoplasms has gradually increased in recent years. There are few reports concerning female patients with multiple primary malignant neoplasms of breast cancer or genitalia malignancies. In this study, we aimed to analyze the clinical characteristics and prognosis of multiple primary malignant neoplasms in female patients with breast cancer or genitalia malignancies, as well as further explore the factors that affect the survival. Methods We collected clinical data on 80 female patients diagnosed with multiple primary malignant neoplasms of the breast or genitalia, described their clinical features. Furthermore, we calculated the survival and prognostic factors for 52 participants. Results In our study, the prevalence rate of multiple primary malignant neoplasms was 0.66% (367/55404). Corresponding to female patients with multiple primary malignant neoplasms of breast cancer or genitalia malignancies, it was 1.4% (80/5707). the median age of diagnosis for the first tumor was 48 years, and the median age of diagnosis for the second tumor was 52 years. Regarding the interval, 67.57% (50/74) of patients were within five years. Most tumors were located in the breast (44.68%), followed by the uterus (20.21%), the ovary (17.02%), and the cervix (15.96%). The overall 12-, 36-and 60-month survival rates of the patients were 86.4%, 74.3%, and 69.8%. For the female patients, the stage (III-IV) (P = 0.046), non-radical surgery (P = 0.002), and types of the last tumor (breast cancer or genitalia malignancies) (P = 0.019) were associated with the poor prognosis. Conclusions Female patients with breast cancer or genital malignancies should pay attention to screening for the second tumor, especially within 4 years after the first tumor diagnosed. Furthermore, during tumor screening, it may be recommended for these patients to focus on colorectal cancer and lung cancer. Compared with previous studies, in addition to clinical staging and types of surgery, we found whether the last tumor was breast cancer or genitalia malignancies should also be considered a prognostic factor.
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Affiliation(s)
- Li Xiao
- Medical Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Tiantian Cao
- Intensive Care Unit, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiali Ou
- Medical Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Weijiang Liang
- Medical Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
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Romano C, Di Gregorio S, Pennisi MS, Tirrò E, Broggi G, Caltabiano R, Manzella L, Ruggieri M, Vigneri P, Di Cataldo A. Multiple primary malignances managed with surgical excision: a case report with next generation sequencing analysis. Mol Biol Rep 2022; 49:9059-9064. [PMID: 35715605 DOI: 10.1007/s11033-022-07630-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Multiple primary malignancies (MPM) are defined as tumors originating in the same individual without any correlation between them. In addition to morphological and immunohistochemical analyses, sensitive DNA sequencing methods such as next generation sequencing (NGS) may help to discriminate the common or different genetic alterations driving each malignancy, to better diagnose these uncommon cases. METHODS AND RESULTS Here we report the case of a man who developed a poorly differentiated gastric adenocarcinoma invading the pancreas followed, two years later, by a colorectal cancer involving also the kidney and the diaphragm. Despite the advanced stage of both diseases, adjuvant chemotherapy was successful. While the second tumor was initially interpreted as a relapse of his stomach cancer, NGS-based mutation profiling of the two carcinomas revealed two distinct malignances, independently developing in different times and indicative of metachronous MPM. Indeed, sequencing of cancer-associated genes identified somatic mutations only in the first gastric cancer, besides germline variants on three different genes (PDGFRA, APC and TP53). However, analysis of both somatic and germline mutations with bio-informatics prediction tools failed to find a correlation between these variants and the unexpectedly good prognosis of both cancers. CONCLUSIONS In summary, NGS analysis contributed to defined different molecular profiles for two tumors developed in the span of two years, thus allowing diagnosing the case as MPN. However, NGS was unable to establish a direct correlation between the identified alterations and cancer development.
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Affiliation(s)
- Chiara Romano
- Department of Clinical and Experimental Medicine, University of Catania, 95123, Catania, Italy. .,Center of Experimental Oncology and Hematology, A.O.U. Policlinico "G. Rodolico - San Marco", 95123, Catania, Italy.
| | - Sandra Di Gregorio
- Department of Clinical and Experimental Medicine, University of Catania, 95123, Catania, Italy.,Center of Experimental Oncology and Hematology, A.O.U. Policlinico "G. Rodolico - San Marco", 95123, Catania, Italy
| | - Maria Stella Pennisi
- Department of Clinical and Experimental Medicine, University of Catania, 95123, Catania, Italy.,Center of Experimental Oncology and Hematology, A.O.U. Policlinico "G. Rodolico - San Marco", 95123, Catania, Italy
| | - Elena Tirrò
- Center of Experimental Oncology and Hematology, A.O.U. Policlinico "G. Rodolico - San Marco", 95123, Catania, Italy.,Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, 90127, Palermo, Italy
| | - Giuseppe Broggi
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Anatomic Pathology, University of Catania, 95123, Catania, Italy
| | - Rosario Caltabiano
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Anatomic Pathology, University of Catania, 95123, Catania, Italy
| | - Livia Manzella
- Department of Clinical and Experimental Medicine, University of Catania, 95123, Catania, Italy.,Center of Experimental Oncology and Hematology, A.O.U. Policlinico "G. Rodolico - San Marco", 95123, Catania, Italy
| | - Martino Ruggieri
- Unit of Rare Diseases of the Nervous System in Childhood, Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, 95123, Catania, Italy
| | - Paolo Vigneri
- Department of Clinical and Experimental Medicine, University of Catania, 95123, Catania, Italy.,Center of Experimental Oncology and Hematology, A.O.U. Policlinico "G. Rodolico - San Marco", 95123, Catania, Italy
| | - Antonio Di Cataldo
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, 95123, Catania, Italy
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Nkosi D, Miller CA, Jajosky AN, Oltvai ZN. Incidental discovery of acute myeloid leukemia during liquid biopsy of a lung cancer patient. Cold Spring Harb Mol Case Stud 2022; 8:mcs.a006201. [PMID: 35732498 PMCID: PMC9235846 DOI: 10.1101/mcs.a006201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/25/2022] [Indexed: 11/25/2022] Open
Abstract
Liquid biopsy is considered an alternative to standard next-generation sequencing (NGS) of solid tumor samples when biopsy tissue is inadequate for testing or when testing of a peripheral blood sample is preferred. A common assumption of liquid biopsies is that the NGS data obtained on circulating cell-free DNA is a high-fidelity reflection of what would be found by solid tumor testing. Here, we describe a case that challenges this widely held assumption. A patient diagnosed with lung carcinoma showed pathogenic IDH1 and TP53 mutations by liquid biopsy NGS at an outside laboratory. Subsequent in-house NGS of a metastatic lymph node fine-needle aspiration (FNA) sample revealed two pathogenic EGFR mutations. Morphologic and immunophenotypic assessment of the patient's blood sample identified acute myeloid leukemia, with in-house NGS confirming and identifying pathogenic IDH1, TP53, and BCOR mutations, respectively. This case, together with a few similar reports, demonstrates that caution is needed when interpreting liquid biopsy NGS results, especially if they are inconsistent with the presumptive diagnosis. Our case suggests that routine parallel sequencing of peripheral white blood cells would substantially increase the fidelity of the obtained liquid biopsy results.
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Affiliation(s)
- Dingani Nkosi
- Department of Pathology and Laboratory Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York 14642, USA
| | - Caroline A Miller
- Department of Pathology and Laboratory Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York 14642, USA
| | - Audrey N Jajosky
- Department of Pathology and Laboratory Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York 14642, USA
| | - Zoltán N Oltvai
- Department of Pathology and Laboratory Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York 14642, USA
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Paran M, Shulman K, Kessel B, Dagan J. Synchronous Malignancies Identified by PET-CT Scan in Breast Cancer Patients. Rambam Maimonides Med J 2022; 13:RMMJ.10472. [PMID: 35482458 PMCID: PMC9049150 DOI: 10.5041/rmmj.10472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Breast cancer is a common malignancy and a common cause of cancer-related mortality in women. Pre-treatment workup of breast cancer does not routinely include positron emission tomography scans. We aimed to review cases of women with breast cancer and a synchronous second primary malignancy. We present three cases of women with non-metastatic cancer in whom a synchronous second primary malignancy was found. Synchronous, second primary malignancies which were identified included rectal cancer, gastrointestinal stromal tumor, and non-small cell lung cancer. All second primary malignancies were identified by a PET-CT scan. In conclusion, PET-CT may be used for detection of secondary primary malignancies in select breast cancer patients.
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Affiliation(s)
- Maya Paran
- Division of General Surgery, Hillel Yaffe Medical Center, Hadera, Israel
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
- To whom correspondence should be addressed. E-mail:
| | - Katerina Shulman
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
- Oncology Service, Clalit Health Services, Lady Davis Carmel Hospital, Haifa, Israel
| | - Boris Kessel
- Division of General Surgery, Hillel Yaffe Medical Center, Hadera, Israel
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
| | - Jasmin Dagan
- Division of General Surgery, Hillel Yaffe Medical Center, Hadera, Israel
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
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Ediz C, Akan S, Huseyin Tavukcu H, Kayhan ME, Yilmaz O. Prognosis of primary or metachronous prostate cancer in multiple primary genitourinary cancers; a single center experience with long-term results. Aging Male 2021; 24:37-41. [PMID: 34338118 DOI: 10.1080/13685538.2020.1817368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE This study aims to analyze the challenges, approaches and long-term results of primary or metachronous prostate cancer (PCa) in cases with multiple primary genitourinary cancers. METHODOLOGY A total of 17 patients were included in the study. Patients with multiple primary genitourinary cancers were divided into two groups according to the diagnosis of primary or metachronous PCa as group 1 and group 2. RESULTS The median age of patients was similar in both groups. The median smoking status (pack-years) was higher in group 2 than group 1. The median prostate-specific antigen (PSA) level was higher in group 1 than group 2. The median follow-up time from primary to the metachronous tumour was higher in group 1 than group 2. The rate of recurrence in PCa was higher in group 1 than group 2. No statistically significant difference was observed in terms of patients' age, smoking status, PSA levels at diagnosis of PCa and biochemical recurrence or metastasis between the two groups (p > 0.05). CONCLUSION Primary PCa cases may progress more aggressively than metachronous PCa cases. Biochemical recurrence and metastasis may be less threatening in metachronous PCa cases than primary cases. Therefore, aggressive treatment can be avoided for metachronous PCa cases.
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Affiliation(s)
- Caner Ediz
- Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey
| | - Serkan Akan
- Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey
| | - Hasan Huseyin Tavukcu
- Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey
| | - Muhammed Esad Kayhan
- Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey
| | - Omer Yilmaz
- Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul, Turkey
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Lee HY, Hsieh MS, Liao HC, Chen PH, Chiang XH, Tsou KC, Tsai TM, Chuang JH, Lin MW, Hsu HH, Chen JS. Previous Extrapulmonary Malignancies Impact Outcomes in Patients With Surgically Resected Lung Cancer. Front Surg 2021; 8:747249. [PMID: 34676241 PMCID: PMC8523860 DOI: 10.3389/fsurg.2021.747249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/06/2021] [Indexed: 11/17/2022] Open
Abstract
Background: As the overall survival of patients with cancer continues to improve, the incidence of second primary malignancies seems to be increasing. Previous studies have shown controversial results regarding the survival of patients with primary lung cancer with previous extrapulmonary malignancies. This study aimed to determine the clinical picture and outcomes of this particular subgroup of patients. Materials and Methods: We included 2,408 patients who underwent pulmonary resection for primary lung cancer at our institute between January 1, 2011 and December 30, 2017 in this retrospective study. Medical records were extracted and clinicopathological parameters and postoperative prognoses were compared between patients with lung cancer with and without previous extrapulmonary malignancies. Results: There were 200 (8.3%) patients with previous extrapulmonary malignancies. Breast cancer (30.5%), gastrointestinal cancer (17%), and thyroid cancer (9%) were the most common previous extrapulmonary malignancies. Age, sex, a family history of lung cancer, and preoperative carcinoembryonic antigen levels were significantly different between the two groups. Patients with previous breast or thyroid cancer had significantly better overall survival than those without previous malignancies. Conversely, patients with other previous extrapulmonary malignancies had significantly poorer overall survival (p < 0.001). The interval between the two cancer diagnoses did not significantly correlate with clinical outcome. Conclusion: Although overall survival was lower in patients with previous extrapulmonary malignancies, previous breast or thyroid cancer did not increase mortality. Our findings may help surgeons to predict prognosis in this subgroup of patients with primary lung cancer.
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Affiliation(s)
- Hsin-Ying Lee
- Department of Medicine, National Taiwan University, Taipei, Taiwan
| | - Min-Shu Hsieh
- Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hsien-Chi Liao
- Department of Traumatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Pei-Hsing Chen
- Department of Surgery, National Taiwan University Hospital Yun-Lin Branch, Douliu, Taiwan
| | - Xu-Heng Chiang
- Department of Surgery, National Taiwan University Hospital Yun-Lin Branch, Douliu, Taiwan
| | | | - Tung-Ming Tsai
- Department of Surgical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Jen-Hao Chuang
- Department of Surgical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Mong-Wei Lin
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hsao-Hsun Hsu
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jin-Shing Chen
- Department of Surgical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Li Q, Zhu F, Xiao Y, Liu T, Liu X, Zhang L, Wu G. Synchronous double primary lymphoma and thyroid cancer: A single-institution retrospective study. Medicine (Baltimore) 2021; 100:e27061. [PMID: 34596109 PMCID: PMC8483851 DOI: 10.1097/md.0000000000027061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 06/13/2021] [Accepted: 08/05/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT Synchronous double primary malignancies of lymphoma and thyroid cancer are rare. In this retrospective study, we investigated the pathology, clinical characteristics, and treatment outcomes of patients with synchronous lymphoma and thyroid cancer.Of the 1156 newly diagnosed lymphoma patients treated in our hospital between January 1, 2016 and February 1, 2021, 8 cases had lymphoma complicated with thyroid cancer. The clinical data and treatment strategies of 8 cases with synchronous lymphoma and thyroid cancer were retrospectively analyzed.The median age of patients was 56 (25-64) years. All the 8 patients were female and papillary thyroid cancer. Only 1 patient had peripheral T-cell lymphoma, and the other 7 were B-cell lymphoma. Seven of 8 patients had normal free triiodothyronine and free thyroxine at the time of diagnosis. Seven thyroid cancer patients received total thyroidectomy and levothyroxine and the remaining 1 patient has a plan for surgery. At the last follow-up, 7 patients with B-cell lymphoma are alive; the patient with peripheral T-cell lymphoma complicated with thyroid cancer died due to lymphoma progression.Synchronous lymphoma and thyroid cancer are more predominant in women. Histologically, B-cell lymphomas and papillary thyroid cancer subtypes are more common. Attention should be paid to the presence of thyroid nodules in the diagnosis of lymphoma. Biopsy or ultrasound-guided fine needle aspiration of the suspicious thyroid nodule should be performed to exclude thyroid malignancy.
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Dayer N, Fasquelle F, Salati E, Dietrich G. Multiple primary malignancies: synchronous lymphoma, pancreatic neuroendocrine tumour and colorectal cancer. BMJ Case Rep 2021; 14:14/6/e241938. [PMID: 34088689 PMCID: PMC8183193 DOI: 10.1136/bcr-2021-241938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 67-year-old woman underwent a medical check-up by her general practitioner after complaining of atypical pain in the shoulder girdle. Due to the important inflammatory syndrome noticed on blood testing, a polymyalgia rheumatica was suspected and she was started on corticosteroid treatment with good clinical response, but no impact on inflammation. She underwent extensive imaging with a thoraco-abdominal CT scanner that demonstrated a pancreatic mass, then later a PET-CT showed 3 different hyperactive lesions. Biopsies then revealed simultaneous diffuse large B-cell lymphoma (DLBCL), colorectal adenocarcinoma and pancreatic neuroendocrine tumour. She benefited from low rectal endoscopic excision of the colorectal tumour, R-CHOP chemotherapy for DLBCL and laparoscopic left pancreatectomy. Successful treatment required a good multidisciplinary collaboration between the different specialists. The patient made a good recovery and achieved complete remission at 1 year. This an unusual presentation of multiple primary malignancies.
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Affiliation(s)
| | | | | | - Gilles Dietrich
- Orthopedic Surgery, Hôpital Riviera-Chablais, Rennaz, Switzerland
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Sumiya R, Ito K, Takemura N, Miyazaki H, Arakawa R, Kato N, Aozasa N, Mihara F, Kokudo N. Seventeen primary malignant neoplasms involving the skin, ovary, esophagus, colon, oral cavity, and ear canal: a case report and review of the literature. Clin J Gastroenterol 2021; 14:980-987. [PMID: 34019222 DOI: 10.1007/s12328-021-01444-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 05/15/2021] [Indexed: 12/01/2022]
Abstract
Multiple primary malignant neoplasm (MPMN) is a rare disease with two or more malignant neoplasms in one patient. In less than 0.1% of cancer patients, four or more occur. MPMN is frequently associated with hereditary cancer syndrome, although in rare cases, it is not. A female patient developed 17 MPMNs. Although they were successfully treated with surgery, radiation, and adjuvant chemotherapy, the patient died from the recurrence of ovarian cancer. To explore genetic susceptibility to MPMN, immunohistochemical analysis, microsatellite instability analysis, germ line exome sequencing, and unscheduled DNA synthesis assays were performed. However, the results of immunohistochemical analysis and microsatellite instability indicated that there were no known hereditary cancer syndromes, and exome sequencing with 88 representative genes associated with hereditary cancer syndrome revealed no variants. An unscheduled DNA synthesis assay to rule out xeroderma pigmentosum was also performed, but the result was negative. While the presence of multiple neoplasms is rare, the present case represents 17 primary neoplasms with no associations with hereditary cancer syndrome. Although the cause of MPMN was not detected in this patient, careful follow-up and deliberate cancer screening enabled successful disease management over 17 years from the appearance of the first neoplasm.
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Affiliation(s)
- Ryusuke Sumiya
- Department of Surgery, National Center for Global Health and Medicine, Hepato-Biliary-Pancreatic Surgery Division, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Kyoji Ito
- Department of Surgery, National Center for Global Health and Medicine, Hepato-Biliary-Pancreatic Surgery Division, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Nobuyuki Takemura
- Department of Surgery, National Center for Global Health and Medicine, Hepato-Biliary-Pancreatic Surgery Division, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
| | - Hideki Miyazaki
- Pathology Division of Clinical Laboratory, National Center for Global Health and Medicine, Tokyo, Japan
| | - Reiko Arakawa
- Medical Genomics Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norihiro Kato
- Medical Genomics Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Naohiko Aozasa
- Department of Dermatology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Fuminori Mihara
- Department of Surgery, National Center for Global Health and Medicine, Hepato-Biliary-Pancreatic Surgery Division, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
| | - Norihiro Kokudo
- Department of Surgery, National Center for Global Health and Medicine, Hepato-Biliary-Pancreatic Surgery Division, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
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Komatsu H, Izumi N, Tsukioka T, Inoue H, Miyamoto H, Ito R, Kimura T, Nishiyama N. Surgical outcomes of primary lung cancers following esophagectomy for primary esophageal carcinoma. Jpn J Clin Oncol 2021; 51:786-792. [PMID: 33442741 DOI: 10.1093/jjco/hyaa254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/22/2020] [Accepted: 12/06/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The aim of this retrospective study is to evaluate the perioperative complications and prognosis of patients with a history of resected esophageal carcinoma who subsequently underwent pulmonary resection of a primary lung cancer. METHODS The study cohort comprised 23 patients who had undergone curative resection of a primary lung cancer following esophagectomy for a primary esophageal carcinoma. Clinical characteristics and surgical outcomes were analyzed. RESULTS The initial treatment for esophageal carcinoma was esophagectomy by thoracotomy in 10 patients and video assisted thoracoscopic surgery in 13. The treatments for lung cancer comprised wedge resection in three patients, segmentectomy in seven and lobectomy in 13. The pulmonary resections were performed by thoracotomy in six and video assisted thoracoscopic surgery in 17. The average operating time for the lung cancer surgeries was 202 min and average blood loss 122 ml. There were no perioperative deaths or severe complications. Three- and Five-year overall survival rates were 78.0% and 68.2%. According to univariate survival analysis, age, restrictive ventilatory impairment and histology of lung cancer were significant predictors of poor prognosis (all P < 0.05). Significantly more of the patients with than without restrictive ventilatory impairment died of other diseases (P = 0.0036). CONCLUSIONS Pulmonary resection for primary lung cancers following esophagectomy for esophageal carcinoma is acceptable in selected patients. Such surgery requires caution concerning intrathoracic adhesions and postoperative prolonged air leakage. Patients with restrictive ventilatory impairment had a poorer prognosis, and the indication for surgery in these patients should be carefully considered.
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Affiliation(s)
- Hiroaki Komatsu
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Nobuhiro Izumi
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Takuma Tsukioka
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Hidetoshi Inoue
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Hikaru Miyamoto
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Ryuichi Ito
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Takuya Kimura
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
| | - Noritoshi Nishiyama
- Department of Thoracic Surgery, Osaka City University Hospital, Osaka, Japan
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Esmati E, Rezaei S, Jafari F. A case of multiple primary malignancies including peritoneal mesothelioma surviving over 11 years. Clin Case Rep 2021; 9:e04096. [PMID: 34026139 PMCID: PMC8133086 DOI: 10.1002/ccr3.4096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/03/2021] [Accepted: 03/13/2021] [Indexed: 01/10/2023] Open
Abstract
Multiple primary malignancies are exceedingly rare, but they may occur sequentially in a patient, so in the follow-up of patients with a history of malignancy, always pay attention to second and third primary malignancies as well.
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Affiliation(s)
- Ebrahim Esmati
- Radiation Oncology Research Center (RORC)Cancer InstituteTehran University of Medical SciencesTehranIran
| | - Saeed Rezaei
- Radiation Oncology Research Center (RORC)Cancer InstituteTehran University of Medical SciencesTehranIran
| | - Fatemeh Jafari
- Radiation Oncology Research Center (RORC)Cancer InstituteTehran University of Medical SciencesTehranIran
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Kuhara Y, Hashimoto Y, Hirahara S, Kubota H, Shirakawa K, Toyota K, Yano R, Kobayashi H, Yokoyama Y, Sakashita Y, Murakami Y, Taniyama K, Miyamoto K. Triple metachronous primary pancreatic and gallbladder cancer associated with pancreaticobiliary maljunction: a case report. Surg Case Rep 2021; 7:81. [PMID: 33825072 PMCID: PMC8024430 DOI: 10.1186/s40792-021-01160-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Metachronous pancreatic and gallbladder cancer is a rare condition and has a dismal prognosis. Herein, we present a patient with triple metachronous primary pancreatic and gallbladder cancer associated with pancreaticobiliary maljunction who achieved long-term survival after undergoing repeat curative surgery. CASE PRESENTATION A 65-year-old female patient with advanced gallbladder cancer associated with pancreaticobiliary maljunction underwent extended cholecystectomy with extrahepatic bile duct resection. The pathological diagnosis was T3N0M0 stage III A papillary adenocarcinoma with hepatic invasion. During a monthly follow-up, a diffuse hypovascular 2.0 × 1.5-cm mass was detected in the pancreatic head 6.2 years after the initial surgery. Hence, the patient underwent pancreaticoduodenectomy. Histological examination revealed T3N0M0 stage IIA well-differentiated adenocarcinoma without lymph node metastases. Marked inflammatory reaction was observed in the non-cancerous lesions of the proximal pancreatic head parenchyma containing bile pigment within ductular lumens. After 12.5 years from the initial surgery, total pancreatectomy for a 4.0 × 3.0-cm mass in the remnant pancreas was performed. Histological examination revealed T3N1M0 stage IIB moderately differentiated adenocarcinoma with lymph node metastases. Hence, surgical curative resection was achieved. Based on the pathological findings, a definitive diagnosis of triple metachronous pancreatic and gallbladder cancer was made. The pathology suggests no precursor lesions such as pancreatic intraepithelial neoplasia (PanIN) and atypical flat lesions, but marked inflammations in the non-cancerous lesions, strengthening our hypothesis that chronic inflammation induced by the pancreaticobiliary maljunction is related to carcinogenesis of the pancreas. Despite further adjuvant chemotherapy, the patient's general condition worsened; however, she remained alive 15.2 years after the initial surgery while receiving the best supportive care. CONCLUSIONS Repeat curative surgery for triple metachronous cancer was associated with a favorable prognosis. Both the biliary tract and the pancreas should be closely monitored during follow-up among patients with pancreaticobiliary maljunction, which can be managed with curative surgery.
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Affiliation(s)
- Yuta Kuhara
- Department of Surgery, Hiroshima Memorial Hospital, Honkawa-cho1-4-3, Naka-ku, Hiroshima, 730-0802, Japan.
| | - Yasushi Hashimoto
- Department of Surgery, Hiroshima Memorial Hospital, Honkawa-cho1-4-3, Naka-ku, Hiroshima, 730-0802, Japan
| | - Satoshi Hirahara
- Department of Surgery, Hiroshima Memorial Hospital, Honkawa-cho1-4-3, Naka-ku, Hiroshima, 730-0802, Japan
| | - Haruna Kubota
- Department of Surgery, Hiroshima Memorial Hospital, Honkawa-cho1-4-3, Naka-ku, Hiroshima, 730-0802, Japan
| | - Kenji Shirakawa
- Department of Surgery, Hiroshima Memorial Hospital, Honkawa-cho1-4-3, Naka-ku, Hiroshima, 730-0802, Japan
| | - Kazuhiro Toyota
- Department of Surgery, Hiroshima Memorial Hospital, Honkawa-cho1-4-3, Naka-ku, Hiroshima, 730-0802, Japan
| | - Raita Yano
- Department of Surgery, Hiroshima Memorial Hospital, Honkawa-cho1-4-3, Naka-ku, Hiroshima, 730-0802, Japan
| | - Hironori Kobayashi
- Department of Surgery, Hiroshima Memorial Hospital, Honkawa-cho1-4-3, Naka-ku, Hiroshima, 730-0802, Japan
| | - Yujiro Yokoyama
- Department of Surgery, Hiroshima Memorial Hospital, Honkawa-cho1-4-3, Naka-ku, Hiroshima, 730-0802, Japan
| | - Yoshihiro Sakashita
- Department of Surgery, Hiroshima Memorial Hospital, Honkawa-cho1-4-3, Naka-ku, Hiroshima, 730-0802, Japan
| | - Yoshiaki Murakami
- Department of Surgery, Hiroshima Memorial Hospital, Honkawa-cho1-4-3, Naka-ku, Hiroshima, 730-0802, Japan
| | - Kiyomi Taniyama
- Department of Pathology, Hiroshima Memorial Hospital, Hiroshima, Japan
| | - Katsunari Miyamoto
- Department of Surgery, Hiroshima Memorial Hospital, Honkawa-cho1-4-3, Naka-ku, Hiroshima, 730-0802, Japan
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Li Q, Dong Y, Pan Y, Tang H, Li D. Case Report: Clinical Responses to Tislelizumab as a First-Line Therapy for Primary Hepatocellular Carcinoma With B-Cell Indolent Lymphoma. Front Immunol 2021; 12:634559. [PMID: 33868256 PMCID: PMC8044442 DOI: 10.3389/fimmu.2021.634559] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/03/2021] [Indexed: 12/24/2022] Open
Abstract
Background As an emerging therapy with a promising efficacy, immunotherapy has been widely used in the treatment of solid tumors and hematologic malignancies. This clinical study compares the efficacy of tislelizumab, a domestic immune checkpoint inhibitor (ICI), to that of sorafenib when used as a first-line therapeutic option in hepatocellular carcinoma (HCC), and the concurrence of HCC and non-Hodgkin's lymphoma (NHL) is rare, especially in the treatment of ICIs. Case presentation A 61-year-old patient presenting with primary HCC and indolent B-cell lymphoma had a partial clinical response to tislelizumab for his primary HCC. Besides, we described a phenomenon of pseudo-progression and delayed diagnosis of his lymphoma during a long course of treatment. Conclusion Tislelizumab, an immunotherapeutic option with a favorable efficacy and toxicity, can be used to manage double primary tumors. However, studies should aim to elucidate the probable mechanisms of this therapy. Pseudo-progression and separation remission make the treatment of double primary tumors even more challenging, which calls for additional caution in patients undergoing immunotherapy to avoid misdiagnosis and, therefore, begin early appropriate interventions.
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MESH Headings
- Antibodies, Monoclonal, Humanized/therapeutic use
- Carcinoma, Hepatocellular/diagnostic imaging
- Carcinoma, Hepatocellular/drug therapy
- Carcinoma, Hepatocellular/immunology
- Carcinoma, Hepatocellular/metabolism
- Humans
- Immune Checkpoint Inhibitors/therapeutic use
- Liver Neoplasms/diagnostic imaging
- Liver Neoplasms/drug therapy
- Liver Neoplasms/immunology
- Liver Neoplasms/metabolism
- Lymphoma, B-Cell/diagnostic imaging
- Lymphoma, B-Cell/drug therapy
- Lymphoma, B-Cell/immunology
- Lymphoma, B-Cell/metabolism
- Male
- Middle Aged
- Neoplasms, Multiple Primary/diagnostic imaging
- Neoplasms, Multiple Primary/drug therapy
- Neoplasms, Multiple Primary/immunology
- Neoplasms, Multiple Primary/pathology
- Treatment Outcome
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Affiliation(s)
| | | | | | | | - Da Li
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Al-Gahmi A, Alhuthali M, Alrehaili M, Baltow B, Tashkandi E. Unusual Synchronous Association of Solid Tumors with Hematological Malignancies in Multiple Primary Cancers: Case Series and Literature Review. Case Rep Oncol 2021; 14:352-364. [PMID: 33776729 PMCID: PMC7983565 DOI: 10.1159/000514147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 12/28/2020] [Indexed: 11/28/2022] Open
Abstract
The incidence of synchronous multiple primary malignancies (MPMs), which include both solid and hematological malignancy, is considered very rare. In addition, the involvement of sites such as brain, thyroid, and breast are among the least reported in such complex conditions. Here we report five different types of solid tumors including glioblastoma multiforme, thyroid papillary carcinoma, breast invasive ductal carcinoma, colon cancer, and gastric adenocarcinoma that were associated with synchronous five different hematological malignancies in the form of T-cell lymphoblastic non-Hodgkin lymphoma (NHL), nodal marginal zone NHL, diffuse large B-cell NHL, Hodgkin lymphoma, and gastric mucosa-associated lymphoid tissue marginal zone NHL, respectively. The diagnosis of MPMs can be challenging, and there is no standard treatment for such difficult primary malignancies. However, the management of these conditions should be individualized using tumor board discussion and ensuring multidisciplinary coordinated care, besides considering treatment of the more aggressive malignancy before that with the less malignant potential.
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Affiliation(s)
- Aboelkhair Al-Gahmi
- Department of Medical Oncology, Oncology Center, King Abdullah Medical City, Makkah, Saudi Arabia
| | | | - Mohammad Alrehaili
- Department of Medical Oncology, Oncology Center, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Badee Baltow
- Laboratory and Blood Bank, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Emad Tashkandi
- Department of Medical Oncology, Oncology Center, King Abdullah Medical City, Makkah, Saudi Arabia.,College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
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Peng WX, Liu X, Wang QF, Zhou XY, Luo ZG, Hu XC. Heterochronic triple primary malignancies with Epstein-Barr virus infection and tumor protein 53 gene mutation: A case report and review of literature. World J Clin Cases 2021; 9:1184-1195. [PMID: 33644183 PMCID: PMC7896647 DOI: 10.12998/wjcc.v9.i5.1184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/02/2020] [Accepted: 12/16/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The diagnosis and etiology of multiple primary malignant neoplasms (MPMNs) are difficult to establish. Here, we report a case of heterochronic triple primary malignancies with gastric cancer, nasopharyngeal squamous cell cancer, and then rectal cancer.
CASE SUMMARY The patient was first diagnosed with gastric cancer at the age of 33 in 2014 and underwent distal gastrectomy and gastrojejunostomy and six cycles of adjuvant chemotherapy. Three years later, he was diagnosed with nasopharyngeal cancer and treated with radical chemoradiotherapy in 2017. Recently, a mass in the middle of the rectum was resected and reported as ulcerative, moderately to poorly differentiated adenocarcinoma. Research on the etiology of MPMNs showed that Epstein-Barr virus (EBV) infection may be the cause of gastric cancer and nasopharyngeal squamous cell cancer since these two primary lesions were positive for transcripts of EBV-encoded ribonucleic acid using an in situ hybridization EBV-encoded ribonucleic acid probe in formalin-fixed, paraffin-embedded tissue. The cause of rectal cancer may be due to a somatic mutation of tumor protein 53 gene in exon 8 (c.844C>T, p.Arg282Trp) through high-throughput sequencing for the rectal cancer. Appropriate standard therapy for each primary cancer was administered, and the patient has no evidence of cancer disease to date.
CONCLUSION To our knowledge, this is the first report on heterochronic triple primary malignancies whose cause may be associated with EBV infection and tumor protein 53 genetic mutations. The etiological research may not only elucidate the cause of MPMN but also has implications in clinical management.
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Affiliation(s)
- Wen-Xia Peng
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Xin Liu
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Qi-Feng Wang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Xiao-Yan Zhou
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Zhi-Guo Luo
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Xi-Chun Hu
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
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AlBaqmi KH, AlMudaiheem FA, Boghdadly S, AlHussaini KA, Shokor N, AlOudah N. Multiple Primary Malignancies of the Colon, Stomach, and Kidney in a Patient with Bowel Obstruction Requiring Emergency Surgery: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e926472. [PMID: 33243966 PMCID: PMC7703489 DOI: 10.12659/ajcr.926472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Patient: Male, 63-year-old Final Diagnosis: Colon adenocarcinoma Symptoms: Abdominal pain • constipation Medication: — Clinical Procedure: — Specialty: Surgery
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Affiliation(s)
- Kholoud H AlBaqmi
- Department of General Surgery, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Faisal A AlMudaiheem
- Department of General Surgery, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Sami Boghdadly
- Department of General Surgery, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Khadijah A AlHussaini
- Department of Radiology, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Nada Shokor
- Department of Pathology, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Nourah AlOudah
- Department of Pathology, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
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