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Quadruple Multiple Primary Malignancies: Early Detection of Second Primary Malignancy by Esophagogastroduodenoscopy/Colonoscopy Is Crucial for Patients with Classic Kaposi's Sarcoma. Diagnostics (Basel) 2020; 10:diagnostics10040218. [PMID: 32295165 PMCID: PMC7235704 DOI: 10.3390/diagnostics10040218] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/04/2020] [Accepted: 04/09/2020] [Indexed: 02/06/2023] Open
Abstract
Currently, Kaposi's sarcoma (KS) is treated following the recommendations of international guidelines. These guidelines recommend esophagogastroduodenoscopy/colonoscopy for detecting multicentric KS of visceral lesions. Second primary malignancies (SPMs) are also a common KS complication; however, information on their detection and treatment is unfortunately not yet indicated in these guidelines. This paper reports on an 86-year-old man who suffered from quadruple primary malignancies: skin classic KS with colon adenocarcinoma, oral squamous cell carcinoma (maxilla), and well-differentiated stomach adenocarcinoma. Gastric cancer was incidentally detected during esophagogastroduodenoscopy, which was performed to detect visceral KS. We suggest that esophagogastroduodenoscopy/colonoscopy be routinely performed during the follow-up of patients with KS. As SPMs are crucial complications in patients with KS, these malignancies should be detected as early as possible.
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Juric I, Basic-Jukic N. Multiple Primary Malignancies: The First Case of a Combination of a Gastrointestinal Stromal Tumor and Renal Cell Carcinoma in a Kidney Transplant Recipient. Transplant Proc 2019; 51:3070-3071. [PMID: 31611119 DOI: 10.1016/j.transproceed.2019.04.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 04/05/2019] [Indexed: 10/25/2022]
Abstract
There is limited data on multiple primary malignancies in the kidney transplant population. Gastrointestinal stromal tumors (GISTs) are rare tumors in kidney transplant recipients, with only 5 cases reported in the literature to date. GIST patients are at an increased risk for developing additional malignancies, with other histologic types of gastrointestinal tract malignancies being the most frequent and other types of malignancies rare. There is evidence in the literature suggesting an association between GIST and renal cell carcinomas. We report on the first case of a GIST and a renal cell carcinoma in a kidney transplant recipient and in other solid organ transplant recipients.
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Affiliation(s)
- Ivana Juric
- Department of Nephrology, Arterial Hypertension, Dialysis, and Transplantation, University Hospital Centre Zagreb, Zagreb, Croatia.
| | - Nikolina Basic-Jukic
- Department of Nephrology, Arterial Hypertension, Dialysis, and Transplantation, University Hospital Centre Zagreb, Zagreb, Croatia
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Buchberger D, Kreinbrink P, Kharofa J. Proton Therapy in the Treatment of Anal Cancer in Pelvic Kidney Transplant Recipients: A Case Series. Int J Part Ther 2019; 6:28-34. [PMID: 31773046 PMCID: PMC6871631 DOI: 10.14338/ijpt-19-00067.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 06/12/2019] [Indexed: 12/20/2022] Open
Abstract
PURPOSE The incidence of anal cancer in patients with kidney transplants has increased. The definitive treatment for anal cancer is chemotherapy and intensity-modulated radiation therapy. In kidney transplant recipients, sparing the pelvic kidney in the process of delivering radiation to the anus can be challenging. Intensity-modulated proton therapy (IMPT) has been proposed as an alternative to intensity-modulated radiation therapy for the treatment of anal cancer in this population, given its increased ability to spare organs-at-risk. CASE SERIES We present 4 cases of patients with transplanted pelvic kidneys who subsequently developed anal cancer and were treated with IMPT from 2017 to 2019. CONCLUSION Use of IMPT appears to be an acceptable option for the treatment of anal cancer in patients with a pelvic kidney.
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Affiliation(s)
- David Buchberger
- Department of Radiation Oncology, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Paul Kreinbrink
- Department of Radiation Oncology, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Jordan Kharofa
- Department of Radiation Oncology, University of Cincinnati Medical Center, Cincinnati, OH, USA
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Oweira H, Schmidt J, Helbling D, Petrausch U, Schöb O, Mehrabi A, Giryes A, Elhadedy H, Abdel-Rahman O. Impact of liver transplantation on the risk of second malignant tumors among hepatocellular carcinoma patients. Expert Rev Gastroenterol Hepatol 2017; 11:865-869. [PMID: 28697656 DOI: 10.1080/17474124.2017.1355235] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Population-based data on the development of second malignant neoplasms (SMNs) following the diagnosis of hepatocellular carcinoma (HCC) are uncommon. We evaluated this clinical vignette in HCC patients within the Surveillance, Epidemiology and End Results (SEER) database. METHODS The SEER database (1973-2012) was queried using the SEER*Stat program to determine the clinico-pathological features of HCC patients with more than one year survival who developed SMNs. Standardized incidence ratios (SIRs) were calculated to determine the risk of each type of subsequent cancers. Relative risk was assessed to determine the impact of liver transplantation on the development of second malignant neoplasms. RESULTS On SIR analysis, the following sites have an enhanced risk of developing an SMN following the diagnosis of HCC: tongue, anal canal, liver, lung, kidney, thyroid, non-Hodgkin lymphoma (both nodal and extra-nodal disease) and acute monocytic leukemia (P < 0.05 for all sites). A significantly higher RR was found for the development of lung cancer (RR = 2.096), thyroid cancer (RR = 3.045) and non-Hodgkin lymphoma (RR = 3.822) among patients who underwent liver transplantation compared to those who did not (P < 0.05). CONCLUSION There is an excess risk for developing a number of SMNs among patients diagnosed with HCC.
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Affiliation(s)
- Hani Oweira
- a Surgery , Swiss Cancer Institute , Cham , Switzerland.,b Department of General, Visceral and Transplant Surgery , University of Heidelberg , Heidelberg , Germany
| | - Jan Schmidt
- c Surgery , Surgical Center Zurich - Hirslanden Hospital Zurich , Zurich , Switzerland
| | - Daniel Helbling
- d Medical Oncology , Gastrointestinal Tumor Center Zurich (GITZ) , Zurich , Switzerland
| | - Ulf Petrausch
- e Medical Oncology , Swiss Tumor Immunology Institute (SwissTII) , Zurich , Switzerland
| | - Othmar Schöb
- c Surgery , Surgical Center Zurich - Hirslanden Hospital Zurich , Zurich , Switzerland
| | - Arianeb Mehrabi
- b Department of General, Visceral and Transplant Surgery , University of Heidelberg , Heidelberg , Germany
| | - Anwar Giryes
- a Surgery , Swiss Cancer Institute , Cham , Switzerland
| | - Hazem Elhadedy
- b Department of General, Visceral and Transplant Surgery , University of Heidelberg , Heidelberg , Germany
| | - Omar Abdel-Rahman
- f Clinical Oncology Department, Faculty of Medicine , Ain Shams University , Cairo , Egypt
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Santangelo ML, Criscitiello C, Renda A, Federico S, Curigliano G, Dodaro C, Scotti A, Tammaro V, Calogero A, Riccio E, Pisani A, Carlomagno N. Immunosuppression and Multiple Primary Malignancies in Kidney-Transplanted Patients: A Single-Institute Study. BIOMED RESEARCH INTERNATIONAL 2015; 2015:183523. [PMID: 26185750 PMCID: PMC4491567 DOI: 10.1155/2015/183523] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 08/21/2014] [Accepted: 09/30/2014] [Indexed: 12/14/2022]
Abstract
Immunodeficiency is associated with higher cancer incidence. However, it is unknown whether there is a link between immunodeficiency and development of multiple primary malignancies. In the present study we analyse this link focusing on kidney-transplanted patients, as they are at higher risk of developing cancer due to the chronic assumption of immunosuppressants. We followed up 1200 patients who underwent kidney transplantation between 1980 and 2012. A total of 77/1200 kidney-transplanted patients developed cancer and 24 of them developed multiple cancers. Most multiple cancers were synchronous with a nonsignificant association between cancer and rejection episodes. In the general cancer population, one-ninth of patients are at higher risk of developing a second tumor over a lifetime; hence it would be reasonable to conclude that, from a merely theoretical and statistical viewpoint, long-term transplanted patients potentially have a higher risk of developing MPMs. However, data did not confirm this assumption, probably because these patients die before a second primary malignancy appears. Despite many observations on the increased incidence of different tumor types in immunodeficient patients and despite immunosuppression certainly being a predisposing factor for the multicancer syndrome, data so far are not robust enough to justify a correlation between immunodeficiency and multiple primary malignancies in transplanted patients.
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Affiliation(s)
- Michele L. Santangelo
- Department of Advanced BioMedical Sciences, Operative Unit of General Surgery & Transplants, University of Naples Federico II, 80131 Naples, Italy
| | - Carmen Criscitiello
- Division of Early Drug Development for Innovative Therapies, European Institute of Oncology, 20141 Milan, Italy
| | - Andrea Renda
- Department of Advanced BioMedical Sciences, Operative Unit of General Surgery & Transplants, University of Naples Federico II, 80131 Naples, Italy
| | - Stefano Federico
- Department of Public Medicine, Operative Unit of Nephrology, University of Naples Federico II, 80131 Naples, Italy
| | - Giuseppe Curigliano
- Division of Early Drug Development for Innovative Therapies, European Institute of Oncology, 20141 Milan, Italy
| | - Concetta Dodaro
- Department of Advanced BioMedical Sciences, Operative Unit of General Surgery & Transplants, University of Naples Federico II, 80131 Naples, Italy
| | - Alessandro Scotti
- Department of Advanced BioMedical Sciences, Operative Unit of General Surgery & Transplants, University of Naples Federico II, 80131 Naples, Italy
| | - Vincenzo Tammaro
- Department of Advanced BioMedical Sciences, Operative Unit of General Surgery & Transplants, University of Naples Federico II, 80131 Naples, Italy
| | - Armando Calogero
- Department of Advanced BioMedical Sciences, Operative Unit of General Surgery & Transplants, University of Naples Federico II, 80131 Naples, Italy
| | - Eleonora Riccio
- Department of Public Medicine, Operative Unit of Nephrology, University of Naples Federico II, 80131 Naples, Italy
| | - Antonio Pisani
- Department of Public Medicine, Operative Unit of Nephrology, University of Naples Federico II, 80131 Naples, Italy
| | - Nicola Carlomagno
- Department of Advanced BioMedical Sciences, Operative Unit of General Surgery & Transplants, University of Naples Federico II, 80131 Naples, Italy
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Tessari G, Naldi L, Boschiero L, Minetti E, Sandrini S, Nacchia F, Valerio F, Rugiu C, Sassi F, Gotti E, Fonte L, Talamini G, Girolomoni G. Incidence of primary and second cancers in renal transplant recipients: a multicenter cohort study. Am J Transplant 2013; 13:214-21. [PMID: 23057816 DOI: 10.1111/j.1600-6143.2012.04294.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 08/17/2012] [Accepted: 08/24/2012] [Indexed: 02/06/2023]
Abstract
Limited data exist about cancer prognosis and the development of second cancers in renal transplant recipients. In a retrospective cohort study on 3537 patients incidence rates of the first and, if any, of a second cancer, and standardized incidence ratios [SIR (95% CI)] were computed. Two hundred and sixty-three (7.5%) patients developed a NMSC, and 253 (7.2%) another type of cancer after a median follow-up of 6.5 and 9.0 years, respectively. A statistically significant excess risk, if compared to an age- and sex-matched reference general population, was observed for Kaposi sarcoma and NMSC, followed by non-Hodgkin lymphoma and carcinoma of cervix uteri; a small number of unusual cancers such as tumors of the salivary glands, small intestine and thyroid also were detected at a level worthy of additional scrutiny. Ten-year survival rate of all noncutaneous cancers was 71.3%, with lower rates for lung carcinoma and non-Hodgkin lymphoma (0% and 41.7%, respectively). Patients with NMSC had an increased risk of developing a second NMSC [SIR 8.3 (7.0-10.0)], and patients with a primary noncutaneous cancer had increased risk of developing a second noncutaneous cancer [SIR 1.8 (1.2-2.8)], if compared to the whole cohort. Our study underscore that the high risk of primary and second cancer in renal transplant recipients, including unusual cancers.
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Affiliation(s)
- G Tessari
- Section of Dermatology and Venereology, Verona, Italy.
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Affiliation(s)
- Jacques Dantal
- Department of Nephrology and Clinical Immunology, University Hospital Hôtel Dieu, 30 Bd Jean Monnet, 44093 Nantes, France
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