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Bi XR, Zhao SY, Ma YQ, Duan XY, Hu TT, Bi LZ, Cai HY. Multiple primary cancers with gastrointestinal malignant tumors as the first manifestation: Three case reports and review of literature. World J Gastroenterol 2025; 31:100146. [PMID: 40062331 PMCID: PMC11886516 DOI: 10.3748/wjg.v31.i8.100146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Revised: 12/03/2024] [Accepted: 01/13/2025] [Indexed: 01/23/2025] Open
Abstract
BACKGROUND The incidence of malignant gastrointestinal (GI) tumors is increasing, and advancements in medical care have significantly improved patient survival rates. As a result, the number of cases involving multiple primary cancers (MPC) has also increased. The rarity of MPC and the absence of sensitive and specific diagnostic markers often lead to missed or incorrect diagnoses. It is, therefore, of vital importance to improve the vigilance of clinicians and the accurate diagnosis of this disease. Patients with GI malignancies face a higher relative risk of developing additional primary malignant tumors compared to those with other systemic tumors. Vigilant monitoring and follow-up are crucial, especially for high-risk groups, which include older adults, men, those with addictions to alcohol and tobacco, those with a family history of tumors, and those who have undergone radiotherapy. CASE SUMMARY In this article, we report three cases of MPC, each involving malignant tumors of the GI tract as the initial primary carcinoma, offering insights that may aid in effectively managing similar cases. CONCLUSION Patients with GI malignancies face a higher MPC risk. Developing screening and follow-up protocols may enhance detection and treatment outcomes.
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Affiliation(s)
- Xin-Ran Bi
- The First Clinical Medical College of Gansu University of Traditional Chinese Medicine, Lanzhou 730000, Gansu Province, China
- Department of Radiotherapy Center, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
| | - Shuang-Yan Zhao
- The First Clinical Medical College of Gansu University of Traditional Chinese Medicine, Lanzhou 730000, Gansu Province, China
- Department of Radiotherapy Center, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
| | - Yu-Qi Ma
- The First Clinical Medical College of Gansu University of Traditional Chinese Medicine, Lanzhou 730000, Gansu Province, China
- Department of Gastrointestinal Surgery, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
| | - Xiao-Yu Duan
- Department of Radiotherapy Center, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
| | - Ting-Ting Hu
- Department of Radiotherapy Center, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
| | - Lian-Zhu Bi
- Department of Neurology, Hospital of Fengnan District, Tangshan 063300, Hebei Province, China
| | - Hong-Yi Cai
- Department of Radiotherapy Center, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
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Zeng R, Zhou X, Ou K, Chen W, Yang C, Wang T, Li Y, Zha Y, Li M, Zhang J. Case report: Long-term survival in synchronous double primary malignancies of lung adenocarcinomas and esophageal squamous cell carcinoma treated with definitive chemoradiotherapy and SBRT combined with anti-PD-1. Front Immunol 2025; 16:1548176. [PMID: 40028319 PMCID: PMC11867956 DOI: 10.3389/fimmu.2025.1548176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2024] [Accepted: 01/29/2025] [Indexed: 03/05/2025] Open
Abstract
Background The occurrence of multiple primary cancers has become common, and the treatment of such patients is very complex, so it is necessary to combine a variety of individualized treatment methods to achieve better treatment results. Case description This report describes a patient with double primary tumors of lung and esophageal cancer had more than 36 months survival with non-operation treatment. The patient diagnosed as lung adenocarcinomas (LADC) and esophageal squamous cell carcinoma (ESCC), was treated with albumin-bound paclitaxel, nedaplatin, and anti-programmed death 1 (anti-PD-1). The esophageal lesions achieved complete response (CR) after finishing two courses of induction chemotherapy combined with anti-PD-1 followed by definitive chemoradiotherapy (CRT). Radiation pneumonitis (RP) occurred one month after the completion of CRT. The pneumonia was relieved after dexamethasone and moxifloxacin treatment. Then, the lung lesion was treated with oral chemotherapy followed by stereotactic body radiation therapy (SBRT). As of July 2024, the patient has survived for more than 3 years after the above treatments, and the current efficacy evaluation is CR of esophageal lesions, PR of pulmonary lesions. Conclusion The multi-modality approach of systemic therapy combined with localized radiotherapy is an effective treatment in the patients of the double primary malignant tumors of LADC and ESCC. The safety and toxicity of radiotherapy for the thoracic double primary tumors demonstrate acceptability.
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Affiliation(s)
- Rui Zeng
- The First Clinical Medical College, Guangdong Medical University, Zhanjiang, Guangdong, China
- Department of Radiotherapy, People’s Hospital of Zhongshan, Zhongshan, Guangdong, China
| | - Xiaoyun Zhou
- Department of Radiotherapy, People’s Hospital of Zhongshan, Zhongshan, Guangdong, China
- Department of Radiation Oncology, Shenzhen University Medical School, Shenzhen, Guangdong, China
| | - Kexin Ou
- The First Clinical Medical College, Guangdong Medical University, Zhanjiang, Guangdong, China
- Department of Radiotherapy, People’s Hospital of Zhongshan, Zhongshan, Guangdong, China
| | - Wei Chen
- Department of Radiotherapy, People’s Hospital of Zhongshan, Zhongshan, Guangdong, China
| | - Chen Yang
- Department of Radiotherapy, People’s Hospital of Zhongshan, Zhongshan, Guangdong, China
| | - Ting Wang
- Department of Radiotherapy, People’s Hospital of Zhongshan, Zhongshan, Guangdong, China
| | - Yani Li
- Department of Radiotherapy, People’s Hospital of Zhongshan, Zhongshan, Guangdong, China
| | - Yawen Zha
- Department of Radiotherapy, People’s Hospital of Zhongshan, Zhongshan, Guangdong, China
| | - Minying Li
- Department of Radiotherapy, People’s Hospital of Zhongshan, Zhongshan, Guangdong, China
| | - Jingjing Zhang
- The First Clinical Medical College, Guangdong Medical University, Zhanjiang, Guangdong, China
- Department of Radiotherapy, People’s Hospital of Zhongshan, Zhongshan, Guangdong, China
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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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Huang CC, Ying LQ, Chen YP, Ji M, Zhang L, Liu L. Metachronous primary esophageal squamous cell carcinoma and duodenal adenocarcinoma: A case report and review of literature. World J Gastrointest Surg 2023; 15:2627-2638. [PMID: 38111767 PMCID: PMC10725532 DOI: 10.4240/wjgs.v15.i11.2627] [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: 07/10/2023] [Revised: 09/23/2023] [Accepted: 10/26/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND The prevalence of multiple primary malignant neoplasms (MPMNs) is increasing in parallel with the incidence of malignancies, the continual improvement of diagnostic models, and the extended life of patients with tumors, especially those of the digestive system. However, the co-existence of MPMNs and duodenal adenocarcinoma (DA) is rarely reported. In addition, there is a lack of comprehensive analysis of MPMNs regarding multi-omics and the tumor microenvironment (TME). CASE SUMMARY In this article, we report the case of a 56-year-old man who presented with a complaint of chest discomfort and abdominal distension. The patient was diagnosed with metachronous esophageal squamous cell carcinoma and DA in the Department of Oncology. He underwent radical resection and chemotherapy for the esophageal tumor, as well as chemotherapy combined with a programmed death-1 inhibitor for the duodenal tumor. The overall survival was 16.6 mo. Extensive evaluation of the multi-omics and microenvironment features of primary and metastatic tumors was conducted to: (1) Identify the reasons responsible for the poor prognosis and treatment resistance in this case; and (2) Offer novel diagnostic and therapeutic approaches for MPMNs. This case demonstrated that the development of a second malignancy may be independent of the location of the first tumor. Thus, tumor recurrence (including metastases) should be distinguished from the second primary for an accurate diagnosis of MPMNs. CONCLUSION Multi-omics characteristics and the TME may facilitate treatment selection, improve efficacy, and assist in the prediction of prognosis.
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Affiliation(s)
- Chun-Chun Huang
- Department of Oncology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu Province, 210009, China
| | - Le-Qian Ying
- Department of Oncology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu Province, 210009, China
| | - Yan-Ping Chen
- Department of Oncology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu Province, 210009, China
| | - Min Ji
- Department of Oncology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu Province, 210009, China
| | - Lu Zhang
- Department of Oncology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu Province, 210009, China
| | - Lin Liu
- Department of Oncology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu Province, 210009, China
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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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Oshi M, Yamada A, Kimura A, Kataoka T, Kobayashi N, Ichikawa Y, Yamanaka S, Fujii S, Endo I. A Case of BRCA2-Pathogenic Variant Breast Cancer With Metachronous Endometrial Cancer and Pancreatic Cancer. World J Oncol 2023; 14:309-315. [PMID: 37560344 PMCID: PMC10409560 DOI: 10.14740/wjon1658] [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: 07/05/2023] [Accepted: 07/21/2023] [Indexed: 08/11/2023] Open
Abstract
Since the popularization of cancer screening and an improvement in treatment over the last two decades, multiple primary malignant neoplasms (MPMNs) have been increasingly reported. We report a patient who developed metachronous MPMNs in the breast, the endometrium, and the pancreas over a period of 13 years. A 42-year-old woman was first diagnosed with breast cancer and underwent breast-conserving surgery with adjuvant radiation therapy and endocrine therapy. Four years after breast surgery, she was diagnosed with endometrial cancer and underwent a laparoscopic modified radical hysterectomy with bilateral oophorectomy with pelvic lymph node dissection followed by adjuvant chemotherapy. However, there was peritoneal dissemination of endometrial cancer 1 year after surgery, which could be removed laparoscopically followed by adjuvant chemotherapy. Ten years after breast cancer surgery, pleural metastasis of breast cancer was diagnosed and treated by endocrine therapy. Thirteen years after breast cancer surgery, a pancreatic tumor with multiple liver masses emerged. It was difficult to diagnose whether primary or metastasis cancer by the results of the pathological analysis. Finally, we diagnosed primary pancreatic cancer with liver metastasis by clinical examination with the BRCA2-pathogenic variant. These tumors were well responded to chemotherapy and the patient survived during a follow-up period of 8 months. According to MPMNs, breast cancer patients should be followed-up carefully for the possibility of BRCA pathogenic variant and development of different primary malignant neoplasms.
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Affiliation(s)
- Masanori Oshi
- Department of Breast Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Akimitsu Yamada
- Department of Breast Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Aki Kimura
- Department of Breast Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Toshiaki Kataoka
- Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Noritoshi Kobayashi
- Department of Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yasushi Ichikawa
- Department of Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Shoji Yamanaka
- Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Satoshi Fujii
- Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
- Department of Molecular Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Itaru Endo
- Department of Breast Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
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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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Jia MM, Yang B, Ding C, Yao YR, Guo J, Yang HB. Synchronous multiple primary malignant neoplasms in breast, kidney, and bilateral thyroid: A case report. World J Clin Cases 2023; 11:1513-1520. [PMID: 36926403 PMCID: PMC10011999 DOI: 10.12998/wjcc.v11.i7.1513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/02/2023] [Accepted: 02/15/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Multiple primary malignant neoplasms (MPMNs) are rare, while synchronous MPMNs (SMPMNs) are even less common. Owing to the progression of medical technology and the extension of life expectancy, its incidence is gradually increasing.
CASE SUMMARY Although reports of breast and thyroid dual cancers are common, cases of an additional diagnosis of kidney primary cancer within the same individual are rare.
CONCLUSION We present a case of simultaneous MPMN of three endocrine organs, reviewing the relevant literature to enhance our understanding of SMPMNs while emphasizing the increasingly important need for accurate diagnosis and multidisciplinary management whenever this challenging situation arises.
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Affiliation(s)
- Miao-Miao Jia
- Department of General Surgery, Shanxi Bethune Hospital/General Surgery Department, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan 030032, Shanxi Province, China
| | - Bin Yang
- Department of General Surgery, Shanxi Bethune Hospital/General Surgery Department, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan 030032, Shanxi Province, China
| | - Chao Ding
- Department of General Surgery, Shanxi Bethune Hospital/General Surgery Department, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan 030032, Shanxi Province, China
| | - Ya-Rong Yao
- Department of General Surgery, Shanxi Bethune Hospital/General Surgery Department, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan 030032, Shanxi Province, China
| | - Jun Guo
- Department of General Surgery, Shanxi Bethune Hospital/General Surgery Department, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan 030032, Shanxi Province, China
| | - Hai-Bo Yang
- Department of General Surgery, Shanxi Bethune Hospital/General Surgery Department, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan 030032, Shanxi Province, China
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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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Gao H, Wang X, Lai Y, Zhang C, Mi L, Ji X, Wang X, Song Y, Zhu J, Liu W. Different situations of identifying second primary malignant tumors in lymphoma patients with synchronous solid tumors. Cancer Med 2023; 12:8038-8049. [PMID: 36621802 PMCID: PMC10134266 DOI: 10.1002/cam4.5592] [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: 12/02/2021] [Revised: 04/20/2022] [Accepted: 12/22/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND To our knowledge, the different situations of identifying second primary malignant tumors (SPMTs) in lymphoma patients with synchronous solid tumors remain to be comprehensively investigated. METHODS We retrospectively collected information pertaining to lymphoma patients with synchronous solid tumors (diagnosed within 6 months) at Peking University Cancer Hospital & Institute between 2009 and 2019. The non-parametric Aalen-Johansen estimator was applied to calculate cumulative incidence function in the competing risk model. Furthermore, propensity score-matched analysis was performed to compare survival differences in lymphoma patients with or without synchronous solid tumors. RESULTS Thirty-eight patients were enrolled. There were three situations of identifying SPMTs. First, in 15 patients (39.5%), SPMTs were identified before the initiation of any treatment. Among them, priority was given to anti-lymphoma treatment in case of only three patients. Second, in 17 patients (44.7%), SPMTs were unexpectedly detected on surgical specimen assessment; of them, 13 received anti-lymphoma treatment after surgery. Third, in six patients (15.8%), SPMTs were identified after the outset of treatment for the primary tumor; in this population, three of four patients with lymphoma switched toward the treatment plan for SPMTs. The 5-year overall survival was 58.7%. The cumulative incidence function within 5 years was 26.6% for lymphoma and 14.7% for other solid tumors. The early identification of SPMTs was associated with better outcomes (p = 0.048). After balancing the baseline characteristics, no differences in survival were observed between lymphoma patients with and without synchronous solid tumors (p = 0.664). CONCLUSIONS This is the first study to present the different situations of identifying SPMTs in lymphoma patients with synchronous solid tumors. In only <50% patients, SPMTs were identifiable at baseline. SPMT identification at different situations may make it difficult to choose the optimal therapeutic option, which may consequently impact patient survival.
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Affiliation(s)
- Hongye Gao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xiaogan Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yumei Lai
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Pathology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Chen Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Lan Mi
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xinqiang Ji
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Medical Record Statistics, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xiaopei Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Yuqin Song
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Jun Zhu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Weiping Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing, China
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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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12
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Concurrent Tumors Revealed by an Autopsy-A Case Report and Literature Review. Case Rep Gastrointest Med 2022; 2022:2308065. [PMID: 35694200 PMCID: PMC9177346 DOI: 10.1155/2022/2308065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 05/11/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Multiple primary malignant neoplasms are an uncommon phenomenon, given the very low incidence of two or more different tumors, while neoplasm may be limited to a single organ or may involve multiple separate anatomical organs. The main purpose of this study is to highlight the importance of morphological and immunohistochemical tests to distinguish the origin of the primary tumor. Case Presentation. We report the case of a 65-year-old deceased male, presenting multiple tumors in the lung, stomach, kidneys, and adrenal organs. The main symptoms presented by the patient were dyspnea with a range of 77% with oxygen saturation, fatigability, and productive cough. Histopathological examination revealed a solid and papillary lung adenocarcinoma, concurrent with tubular gastric adenocarcinoma. Immunohistochemical testing was mandatory by using a panel of seven monoclonal mouse antibodies (TTF-1, Napsin A, CK7, CK20, p40, synaptophysin, and chromogranin A). The pulmonary tumoral immunophenotype (positive for TTF-1, Napsin A, CK7; negative for CK20, p40, synaptophysin, and chromogranin A) confirms the diagnosis of primary lung ADC and invalidates the hypothesis of a metastasis arisen from a gastric adenocarcinoma or other forms of lung cancer. Conclusion The importance of the ancillary test is to distinguish a primary tumor from a metastatic one.
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13
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Du Y, Duan Y, Zhang L, Gu Z, Zheng X, Li Z, Wang C. A Female With Synchronous Multiple Primary Malignant Tumors in the Esophagogastric Junction, Duodenum and Pancreas: Case Report and Review of the Literature. Front Oncol 2022; 12:890587. [PMID: 35707359 PMCID: PMC9190262 DOI: 10.3389/fonc.2022.890587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 05/02/2022] [Indexed: 11/25/2022] Open
Abstract
The incidence of multiple primary carcinomas (MPCs), which are defined as two or more malignancies detected in an individual person, is gradually increasing around the world. According to the timing of diagnosis for each constituent tumor, MPCs are classified into 2 categories: synchronous MPCs if constituent tumors emerge simultaneously or within 6 months or metachronous MPCs otherwise. In this report, we describe our recent observation and treatment of a female patient with synchronous primary esophagogastric junction adenocarcinoma, duodenal adenocarcinoma and pancreatic ductal adenocarcinoma (PDAC). To the best of our knowledge, this combination has not yet been reported in the literature. A crucial aspect is the decision regarding which tumor to treat initially and how to schedule further treatments according to individual tumor hazards. Our multidisciplinary team devised an individualized treatment regimen for this patient. The patient ultimately achieved an overall survival time of 18 months, which was much longer than the median survival time (6~11 months) of patients with locally advanced pancreatic cancer. Moreover, treating this rare combination raised a series of diagnostic, etiological and therapeutic questions, motivating us to carry out a critical review of the literature. In summary, an individualized treatment strategy with input from a dedicated multidisciplinary team and consideration of all options at different points along the disease trajectory is essential to optimize outcomes for patients with MPC.
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Affiliation(s)
- Yongxing Du
- State Key Laboratory of Molecular Oncology and Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yunjie Duan
- State Key Laboratory of Molecular Oncology and Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lipeng Zhang
- State Key Laboratory of Molecular Oncology and Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Burns and Plastic Surgery, The Fourth Medical Center of PLA General Hospital, Beijing, China
| | - Zongting Gu
- State Key Laboratory of Molecular Oncology and Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaohao Zheng
- State Key Laboratory of Molecular Oncology and Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zongze Li
- State Key Laboratory of Molecular Oncology and Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chengfeng Wang
- State Key Laboratory of Molecular Oncology and Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Chengfeng Wang,
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14
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Yang EJ, Lee JH, Lee AJ, Kim NR, Ouh YT, Kim MK, Shim SH, Lee SJ, Kim TJ, So KA. Multiple Primary Malignancies in Patients with Gynecologic Cancer. J Clin Med 2021; 11:jcm11010115. [PMID: 35011855 PMCID: PMC8745177 DOI: 10.3390/jcm11010115] [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: 12/03/2021] [Revised: 12/18/2021] [Accepted: 12/23/2021] [Indexed: 11/16/2022] Open
Abstract
Objective: To investigate the prevalence and oncologic outcomes of patients with multiple primary malignant tumors (MPMT) with gynecologic cancer. Methods: This retrospective study included 1929 patients diagnosed with gynecologic cancer at a tertiary medical center between August 2005 and April 2021. The clinical data included cancer location, age at primary malignancy diagnosis, interval between primary and secondary cancer, stage of cancer, family history of cancer, genetic testing, dates of last follow-up, recurrence, and death. Results: The prevalence of MPMT with gynecologic cancer in patients was 8.6% and the mean diagnostic period between primary and secondary cancer was 60 months. Furthermore, 20 of the 165 patients with MPMT had multiple primary gynecologic cancers (MPGC), whereas 145 had gynecologic cancer coexisting with non-gynecologic cancer (GNC). Endometrial-ovarian cancer (60%) was the most common coexisting cancer in the MPGC group, whereas the most common non-gynecologic cancer in the GNC group was breast cancer (34.5%). There were 48 patients with synchronous cancer and 117 patients with metachronous cancer. The incidence of synchronous cancer was higher in the MPGC group than in the GNC group (p = 0.037). Significantly more patients had early-stage ovarian cancer in the MPGC group than in the GNC group (p = 0.031). The overall recurrence and mortality rates were 15.8% and 8.5%, respectively, in patients with MPMT. Conclusion: Synchronous cancer incidence was significantly higher in the MPGC than in the GNC group. Early-stage ovarian cancer was more highly diagnosed in patients with MPGC than in those with GNC. A systematic examination after primary cancer diagnosis could facilitate the early diagnosis of secondary primary malignancy, thereby improving patient prognosis.
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Affiliation(s)
- Eun-Jung Yang
- Department of Obstetrics and Gynecology, KonKuk University Hospital, Seoul 05030, Korea; (E.-J.Y.); (J.-H.L.); (A.-J.L.); (N.-R.K.); (S.-H.S.); (S.-J.L.); (T.-J.K.)
| | - Ji-Hyeon Lee
- Department of Obstetrics and Gynecology, KonKuk University Hospital, Seoul 05030, Korea; (E.-J.Y.); (J.-H.L.); (A.-J.L.); (N.-R.K.); (S.-H.S.); (S.-J.L.); (T.-J.K.)
| | - A-Jin Lee
- Department of Obstetrics and Gynecology, KonKuk University Hospital, Seoul 05030, Korea; (E.-J.Y.); (J.-H.L.); (A.-J.L.); (N.-R.K.); (S.-H.S.); (S.-J.L.); (T.-J.K.)
| | - Nae-Ry Kim
- Department of Obstetrics and Gynecology, KonKuk University Hospital, Seoul 05030, Korea; (E.-J.Y.); (J.-H.L.); (A.-J.L.); (N.-R.K.); (S.-H.S.); (S.-J.L.); (T.-J.K.)
| | - Yong-Taek Ouh
- Department of Obstetrics and Gynecology, Grauate School of Medicine, Kangwon National University, Chuncheon 24289, Korea;
| | - Mi-Kyung Kim
- Department of Obstetrics and Gynecology, Ewha Womans University Mokdong Hospital, Seoul 07804, Korea;
| | - Seung-Hyuk Shim
- Department of Obstetrics and Gynecology, KonKuk University Hospital, Seoul 05030, Korea; (E.-J.Y.); (J.-H.L.); (A.-J.L.); (N.-R.K.); (S.-H.S.); (S.-J.L.); (T.-J.K.)
| | - Sun-Joo Lee
- Department of Obstetrics and Gynecology, KonKuk University Hospital, Seoul 05030, Korea; (E.-J.Y.); (J.-H.L.); (A.-J.L.); (N.-R.K.); (S.-H.S.); (S.-J.L.); (T.-J.K.)
| | - Tae-Jin Kim
- Department of Obstetrics and Gynecology, KonKuk University Hospital, Seoul 05030, Korea; (E.-J.Y.); (J.-H.L.); (A.-J.L.); (N.-R.K.); (S.-H.S.); (S.-J.L.); (T.-J.K.)
| | - Kyeong-A So
- Department of Obstetrics and Gynecology, KonKuk University Hospital, Seoul 05030, Korea; (E.-J.Y.); (J.-H.L.); (A.-J.L.); (N.-R.K.); (S.-H.S.); (S.-J.L.); (T.-J.K.)
- Correspondence: ; Tel.: +82-2-2030-7524
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15
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Egawa T, Masuzawa K, Nakayama S, Maeda I, Tsunematsu S, Suzuki Y, Suzuki Y. Synchronous Primary Lung Adenocarcinoma and Hepatocellular Carcinoma Successfully Treated with a Combination of Atezolizumab, Bevacizumab, Carboplatin, and Paclitaxel. Intern Med 2021; 60:3273-3277. [PMID: 33840693 PMCID: PMC8580750 DOI: 10.2169/internalmedicine.6442-20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Chemotherapy for multiple primary malignancies is challenging. We herein report a case of synchronous primary lung adenocarcinoma and hepatocellular carcinoma (HCC). A 72-year-old man was admitted for the evaluation of an abnormal shadow on his lung. Computed tomography revealed a lung nodule in the right upper lobe and multiple liver masses. He was diagnosed with synchronous primary lung adenocarcinoma and HCC. Atezolizumab, bevacizumab, carboplatin, and paclitaxel (ABCP) chemotherapy was efficacious for both tumors. ABCP chemotherapy may be a potential treatment option for synchronous primary lung adenocarcinoma and HCC.
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Affiliation(s)
- Takashi Egawa
- Department of Respiratory Medicine, Kitasato University Kitasato Institute Hospital, Japan
| | - Keita Masuzawa
- Department of Respiratory Medicine, Kitasato University Kitasato Institute Hospital, Japan
| | - Sohei Nakayama
- Department of Respiratory Medicine, Kitasato University Kitasato Institute Hospital, Japan
| | - Ichiro Maeda
- Department of Pathology, Kitasato University Kitasato Institute Hospital, Japan
- Department of Pathology, Kitasato University School of Medicine, Japan
| | - Satoshi Tsunematsu
- Department of Gastroenterology and Hepatology, Kitasato University Kitasato Institute Hospital, Japan
| | - Yukio Suzuki
- Department of Respiratory Medicine, Kitasato University Kitasato Institute Hospital, Japan
| | - Yusuke Suzuki
- Department of Respiratory Medicine, Kitasato University Kitasato Institute Hospital, Japan
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16
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He F, Xia Y, Ling X. Diagnosis and Individualized Treatment of Three Primary Malignant Tumors: A Case Report. BREAST CANCER-TARGETS AND THERAPY 2021; 13:519-527. [PMID: 34526817 PMCID: PMC8437380 DOI: 10.2147/bctt.s321390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 08/21/2021] [Indexed: 11/23/2022]
Abstract
Continuous optimization of diagnosis and treatment of malignant tumors has led to significantly prolonged survival in cancer patients. Despite the recent increase in the incidence of multiple primary malignant tumors (MPMT), it remains rare in clinical practice; therefore, normative guidance on its etiology, diagnosis, and treatment is insufficient. Here we describe the case of a patient with three primary malignant tumors, namely breast cancer, diffuse astrocytoma, and hepatic malignant perivascular epithelioid cell tumors (PEComa) and discuss relevant literature.
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Affiliation(s)
- Fang He
- The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Yunxia Xia
- The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Xiaoling Ling
- Department of Oncology, The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
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17
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Huang L, Meng C, Liu D, Fu XJ. Secondary peripheral T-cell lymphoma and acute myeloid leukemia after Burkitt lymphoma treatment: A case report. World J Clin Cases 2021; 9:7237-7244. [PMID: 34540984 PMCID: PMC8409196 DOI: 10.12998/wjcc.v9.i24.7237] [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: 04/16/2021] [Revised: 05/25/2021] [Accepted: 07/05/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Multiple primary cancer refers to more than one synchronous or sequential cancer in the same individual. Multiple primary cancer always presents as solid cancer or acute myeloid leukemia (AML) secondary to lymphoma. Here, we report a rare case of secondary peripheral T-cell lymphoma and AML after Burkitt lymphoma treatment.
CASE SUMMARY A 54-year-old female patient was admitted to our hospital complaining of edema on her left lower limb. Physical examination revealed multiple superficial lymphadenectasis on her neck and pelvis. Color ultrasonography examination showed multiple uterine fibroids and a solid mass at the lower left side of the abdomen. Pathological biopsy revealed Burkitt lymphoma. After three hyper-CVAD (A + B) regimens, she achieved complete remission. Two years later, lymphadenectasis reoccurred. A relevant biopsy confirmed the diagnosis of peripheral T-cell lymphoma, which was accompanied by gastrointestinal invasion and hemocytopenia. Meanwhile, bone marrow examination revealed AML. On the second day of scheduled treatment, she developed gastrointestinal bleeding, peptic ulcers, and hemorrhagic shock and was critically ill. She was then discharged from the hospital due to financial concerns.
CONCLUSION This is the first report of secondary peripheral T-cell lymphoma and AML after Burkitt lymphoma treatment with heterochronous and synchronal multiple primary cancers.
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Affiliation(s)
- Li Huang
- Department of Hematology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan Province, China
| | - Can Meng
- Department of Hematology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan Province, China
| | - Dan Liu
- Department of Hematology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan Province, China
| | - Xiang-Jun Fu
- Department of Hematology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan Province, China
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18
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Frantsiyants EM, Kaplieva IV, Trepitaki LK, Surikova EI, Bandovkina VA, Neskubina IV, Коtievа IМ, Shumarin KА. Experimental Modeling of Multiple Primary Malignant Processes with One Tumor Suppressed by Another under Conditions of Primary Immunodeficiency. Bull Exp Biol Med 2021; 171:367-369. [PMID: 34302206 DOI: 10.1007/s10517-021-05229-w] [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: 11/20/2020] [Indexed: 10/20/2022]
Abstract
The phenomenon of multiple primary malignant tumors (MPMT) is characterized by the presence of several primary neoplasms in the same patient. An experimental model of MPMT with one dominating tumor was developed. Female BALB/c nude mice received simultaneous subcutaneous inoculation of Guerin's carcinoma (5×105 tumor cells in 0.5 ml saline) and B16/F10 melanoma (0.5 ml suspension diluted 1:20 with saline). Control females received transplantation of either melanoma or carcinoma alone in the same doses and volumes. In animals with MPMT model, tumors appeared 3-fold faster than after isolated transplantation of melanoma or Guerin's carcinoma and were larger by 7.5 and 2.2 times, respectively; the survival of mice with MPMT was lower. Guerin's carcinoma in the MPMT model metastasized to melanoma and almost completely suppressed its growth. Thus, a MPMT model was created with carcinoma suppressing the malignant growth of melanoma.
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Affiliation(s)
- E M Frantsiyants
- National Medical Research Centre for Oncology, Rostov-on-Don, Russia
| | - I V Kaplieva
- National Medical Research Centre for Oncology, Rostov-on-Don, Russia.
| | - L K Trepitaki
- National Medical Research Centre for Oncology, Rostov-on-Don, Russia
| | - E I Surikova
- National Medical Research Centre for Oncology, Rostov-on-Don, Russia
| | - V A Bandovkina
- National Medical Research Centre for Oncology, Rostov-on-Don, Russia
| | - I V Neskubina
- National Medical Research Centre for Oncology, Rostov-on-Don, Russia
| | - I М Коtievа
- National Medical Research Centre for Oncology, Rostov-on-Don, Russia
| | - K А Shumarin
- National Medical Research Centre for Oncology, Rostov-on-Don, Russia
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19
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Salemis NS. Synchronous occurrence of breast cancer and refractory diffuse large B-cell abdominal lymphoma: Management and review of the literature. Intractable Rare Dis Res 2021; 10:131-135. [PMID: 33996360 PMCID: PMC8122319 DOI: 10.5582/irdr.2021.01017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
The synchronous occurrence of primary breast cancer and lymphoid tissue malignant tumors has been rarely reported in the literature. We present an exceedingly rare case of synchronous breast invasive ductal carcinoma with an abdominal diffuse large B-cell lymphoma (DLBCL). A 78-year-old woman who was diagnosed with a luminal A invasive breast cancer on core biopsy, and complaint of progressively worsening low back pain. An abdominal computed tomography (CT) scan that was performed as part of the preoperative staging showed a large abdominal mass measuring 10.5 × 4.8 × 9.5 cm surrounding the lower part of the abdominal aorta, the right common iliac, right external, right internal iliac, and the left internal iliac arteries. A CT-guided fine-needle aspiration biopsy (FNAB) of the abdominal mass was then performed, to exclude the possibility of being an abdominal tumor metastasis of the known primary breast cancer. Histopathological findings were suggestive of DLBCL. Following a multidisciplinary team discussion, chemotherapy was initiated for DLBCL. The tumor however was refractory to multiple chemotherapy regimens and exhibited a highly aggressive clinical course. The diagnostic evaluation and management of the patient are discussed, along with a review of the relevant literature. This case underscores the fact that the presence of synchronous malignancies may pose both diagnostic and treatment challenges. Accurate staging of both malignancies and multidisciplinary team discussion is of utmost importance to guide an optimal therapeutic approach. Histopathological evaluation is essential for both tumors, for the second malignancy not to be misinterpreted as a secondary deposit of the primary one.
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Affiliation(s)
- Nikolaos S. Salemis
- Breast Cancer Surgery Unit, Army General Hospital, Athens, Greece
- IASO Women's Hospital, Athens, Greece
- Address correspondence to:Nikolaos S. Salemis, Breast Cancer Surgery Unit, Army General Hospital, 19 Taxiarhon Street, 19014 Kapandriti, Athens, Greece. E-mail:
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20
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Sarma G, Nath J, Ahmed S, Roy PS, Das G. The First Literature Case Report: Synchronous Squamous Cell Carcinoma of Esophagus and Adenocarcinoma of Gallbladder. J Gastrointest Cancer 2021; 52:1159-1164. [PMID: 33686458 DOI: 10.1007/s12029-021-00624-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Gautam Sarma
- Department of Radiation Oncology, Dr B Borooah Cancer Institute, Guwahati, Assam, 781016, India
| | - Jyotiman Nath
- Department of Radiation Oncology, Dr B Borooah Cancer Institute, Guwahati, Assam, 781016, India.
| | - Shiraj Ahmed
- Department of Oncopathology, Dr B Borooah Cancer Institute, Guwahati, Assam, India
| | - Partha Sarathi Roy
- Department of Medical Oncology, Dr B Borooah Cancer Institute, Guwahati, Assam, India
| | - Gaurav Das
- Department of Surgical Oncology, Dr B Borooah Cancer Institute, Guwahati, Assam, India
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21
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Gene expression profiling for the diagnosis of multiple primary malignant tumors. Cancer Cell Int 2021; 21:47. [PMID: 33514366 PMCID: PMC7846996 DOI: 10.1186/s12935-021-01748-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 01/02/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The incidence of multiple primary malignant tumors (MPMTs) is rising due to the development of screening technologies, significant treatment advances and increased aging of the population. For patients with a prior cancer history, identifying the tumor origin of the second malignant lesion has important prognostic and therapeutic implications and still represents a difficult problem in clinical practice. METHODS In this study, we evaluated the performance of a 90-gene expression assay and explored its potential diagnostic utility for MPMTs across a broad spectrum of tumor types. Thirty-five MPMT patients from Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University and Fudan University Shanghai Cancer Center were enrolled; 73 MPMT specimens met all quality control criteria and were analyzed by the 90-gene expression assay. RESULTS For each clinical specimen, the tumor type predicted by the 90-gene expression assay was compared with its pathological diagnosis, with an overall accuracy of 93.2% (68 of 73, 95% confidence interval 0.84-0.97). For histopathological subgroup analysis, the 90-gene expression assay achieved an overall accuracy of 95.0% (38 of 40; 95% CI 0.82-0.99) for well-moderately differentiated tumors and 92.0% (23 of 25; 95% CI 0.82-0.99) for poorly or undifferentiated tumors, with no statistically significant difference (p-value > 0.5). For squamous cell carcinoma specimens, the overall accuracy of gene expression assay also reached 87.5% (7 of 8; 95% CI 0.47-0.99) for identifying the tumor origins. CONCLUSIONS The 90-gene expression assay provides flexibility and accuracy in identifying the tumor origin of MPMTs. Future incorporation of the 90-gene expression assay in pathological diagnosis will assist oncologists in applying precise treatments, leading to improved care and outcomes for MPMT patients.
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22
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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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Jiang H, Zhao S, Li G. Simultaneous renal clear cell carcinoma and primary clear cell carcinoma of the liver: A case report. Medicine (Baltimore) 2020; 99:e23263. [PMID: 33217850 PMCID: PMC7676612 DOI: 10.1097/md.0000000000023263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
RATIONALE Double primary clear cell carcinomas of the liver (PCCCL) and kidney are extremely rare; moreover, there have been no reported cases of adrenal metastasis from primary clear cell tumors of the liver. PATIENT CONCERNS A 47-year-old male patient was admitted to our clinic with space-occupying lesions in the left kidney and liver during a regular medical examination. DIAGNOSES The tumors in the kidney and liver were diagnosed as primary clear cell carcinoma by histopathological examination. INTERVENTIONS The patient subsequently underwent nephron-sparing surgery of the left kidney and radical partial excision of the right liver lobe by laparoscopic surgery. Transcatheter arterial chemoembolization (TACE) was performed for the patient 2 weeks after tumor resection. One month after the operation, the patient started adjuvant therapy with sorafenib (400 mg twice per day orally). However, follow-up CT imaging revealed a solid mass measuring 1.9 × 2.0 × 2.0 cm in the right adrenal gland at 2 months postoperatively, and then the patient underwent radiofrequency ablation (RFA) for the right adrenal tumor. OUTCOMES The patient remained cancer free for 2 years following the diagnosis despite early right adrenal metastasis. LESSONS Hepatocyte immunostaining is sufficient for the diagnosis of PCCCL.
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Affiliation(s)
- Hua Jiang
- Department of Urology, The Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai
| | - Shanchao Zhao
- Department of Urology, Nanfang Hospital, Southern Medical University/The First School of Clinical Medicine, Southern Medical University, Guangzhou
| | - Ganhong Li
- Department of Urology, The Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai, China
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Liu C, Wang C, Du Z, Xue H, Liu Z. Clinical features and prognosis of duplex primary malignant neoplasms involving chronic myeloid leukemia. Medicine (Baltimore) 2020; 99:e22904. [PMID: 33126344 PMCID: PMC7598785 DOI: 10.1097/md.0000000000022904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
This study was to investigate clinical features and prognosis of duplex primary malignant neoplasms involving chronic myeloid leukemia (CML-DPMNs). Clinical data of thirteen CML-DPMN patients who were admitted to the First Hospital of Jilin University from May 2008 to December 2018 were collected and retrospectively analyzed. Female patients (9/13) were predominant in this cohort study. Nine patients were metachronous DPMNs (metachronous duplex primary malignant neoplasms involving chronic myeloid leukemia) with 5 years median interval time from primary malignancy to secondary malignancy. The other 4 patients were diagnosed as synchronous CML-DPMNs. Seven of the metachronous duplex primary malignant neoplasms involving chronic myeloid leukemia suffered from CML following many years of comprehensive anti-cancer therapy. Two of CML-MDPMN patients had invasive ductal carcinoma of breast after many years of treatment with imatinib. There was no difference between treatment-related CML group and non-treatment-related CML group in regard as the gender, age, white blood cell count, hemoglobin level, platelet count, and risk level. The median overall survival time of these thirteen patients with CML-DPMNs was not reached. In conclusion, female patients are more likely to suffer from the CML-DPMNs in the present article. Overall survival time of patients with DPMNs involving CML could be promising if timely and effective treatment therapy is adopted.
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MESH Headings
- Age Factors
- Anticarcinogenic Agents/therapeutic use
- Breast Neoplasms/drug therapy
- Breast Neoplasms/pathology
- China/epidemiology
- Female
- Humans
- Imatinib Mesylate/therapeutic use
- Incidence
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/blood
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/epidemiology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Male
- Middle Aged
- Neoplasms, Multiple Primary/blood
- Neoplasms, Multiple Primary/diagnosis
- Neoplasms, Multiple Primary/epidemiology
- Neoplasms, Multiple Primary/pathology
- Prognosis
- Retrospective Studies
- Risk Factors
- Sex Factors
- Survival Analysis
- Time Factors
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Affiliation(s)
- Chunshui Liu
- Department of Hematology, The First Hospital of Jilin University, Changchun
| | - Cong Wang
- Department of Hematology, The First Hospital of Jilin University, Changchun
| | - Zhonghua Du
- Department of Hematology, The First Hospital of Jilin University, Changchun
| | - Hongwei Xue
- Department of Lymphoma, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zhihe Liu
- Department of Lymphoma, The Affiliated Hospital of Qingdao University, Qingdao, China
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Li N, Liu X, Song Y, Luo S, Fang B. The Synchronous Presence of Multiple Myelomas and Other Primary Malignant Tumors: Case Series with Literature Review. Cancer Manag Res 2020; 12:2829-2838. [PMID: 32425597 PMCID: PMC7187932 DOI: 10.2147/cmar.s238288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 01/24/2020] [Indexed: 01/30/2023] Open
Abstract
Objective The synchronous presence of multiple myeloma (MM) and other primary malignant tumors (PMTs) were rarely reported. This study aimed to analyze several cases of MM and other PMTs in order to improve clinicians’ understanding of multiple myeloma (MM) with sMPMTs. Methods This study was a retrospective trial. We retrospectively analyzed six cases of the synchronous presence of MM and other PMTs and reviewed the literature to summarize the clinical features and treatment. Results The results showed that five cases of immunoglobulin G (IgG) and one case of kappa light chain; D-S stage: six case of stage III; ISS stage: one case of stage I, two cases of stage II, and three cases of stage III; one case each of gastric cancer (pT2N0MO, stage I), breast cancer (pT1bN0M0, stage I), lung cancer (pT1N0M0, stage I), cervical cancer (stage IB2), thyroid cancer (pT1N0M0, stage I), and diffuse large B-cell lymphoma (Ann-Arbor stage II); three of five patients underwent surgery alone, one patient underwent surgery first and then received chemotherapy at the time of pleural metastasis and the other patient only received radiotherapy; two patients were still alive, three died of progression of MM, and one died of lung cancer. The median survival time was 33.5 months (95% CI, 14.17 to 59.5months). Conclusion The relationship between synchronous MM and other PMTs remains unknown. Clinicians should improve their understanding of MM with sMPMTs by carrying out multidisciplinary collaboration and a patient-oriented approach to optimize treatment and prolong the survival rates of patients.
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Affiliation(s)
- Ning Li
- Department of Oncology, Henan Cancer Hospital, Henan Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Xiyang Liu
- Henan Institute of Haematology, Department of Hematology, Henan Cancer Hospital, Henan Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Yongping Song
- Henan Institute of Haematology, Department of Hematology, Henan Cancer Hospital, Henan Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Suxia Luo
- Department of Oncology, Henan Cancer Hospital, Henan Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Baijun Fang
- Henan Institute of Haematology, Department of Hematology, Henan Cancer Hospital, Henan Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou University, Zhengzhou, People's Republic of China
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26
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Ying X, Zhang H, Chen B, Wu H, Bao L, Qian S, Ying X. Multiple metachronous rare primary malignant tumors: A case report. Thorac Cancer 2019; 10:2050-2053. [PMID: 31454854 PMCID: PMC6775015 DOI: 10.1111/1759-7714.13182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 08/10/2019] [Accepted: 08/10/2019] [Indexed: 01/03/2023] Open
Abstract
Multiple primary malignant tumors (MPMTs) are rarely seen among the patients with malignant neoplasms. Moreover, the existence of five MPMTs in the same patient is an extremely rare phenomenon. In this case, a 42‐year‐old male patient developed five metachronous MPMTs within 16 years and the duration between each malignant tumor shortened with the progression of the disease. Multidisciplinary treatments were used on this patient and he fought against the cancers until the end of his life. Our report provides us with a new awareness of MPMTs, which should be considered when we come across with cancer patients who develop various unexplainable symptoms after the diagnosis of the first neoplasm.
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Affiliation(s)
- Xiaozhen Ying
- Department of Radiotherapy, Lishui Central Hospital, Lishui, China
| | - Heying Zhang
- Department of Emergency, Zhuji People's Hospital of Zhejiang Province, Zhuji, China
| | - Bizheng Chen
- Department of Radiotherapy, Lishui Central Hospital, Lishui, China
| | - He Wu
- Department of Radiotherapy, Lishui Central Hospital, Lishui, China
| | - Liming Bao
- Department of Radiotherapy, Lishui Central Hospital, Lishui, China
| | - Shi Qian
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Interventional Research of Zhejiang Province, Lishui Central Hospital, Lishui, China
| | - Xihui Ying
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Interventional Research of Zhejiang Province, Lishui Central Hospital, Lishui, China
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Aminorroaya A, Khoshniatnikoo M, Farrokhpour H, Vafaeimanesh J, Bagherzadeh M. Squamous cell carcinoma of the lung and pulmonary metastasis of papillary thyroid carcinoma: a case report. J Med Case Rep 2019; 13:259. [PMID: 31422769 PMCID: PMC6699065 DOI: 10.1186/s13256-019-2177-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 06/27/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The coexistence of malignancies in a patient may be explained by the tumor-to-tumor metastasis phenomenon or multiple primary malignant tumors, both of which are not common findings. Here, we are going to present a case with coexistent papillary thyroid carcinoma and primary squamous cell carcinoma of the lung. CASE PRESENTATION A 36-year-old Iranian man presented to our clinic for evaluation of constitutional symptoms. His past medical history was significant for papillary thyroid carcinoma due to which he had undergone total thyroidectomy, cervical lymph node dissection, and radioactive iodine therapy 14 years ago. Six months prior to admission, he received radioactive iodine therapy due to the metastatic involvement of both lungs with papillary thyroid carcinoma in another center with consequent improvement in symptoms. Diffuse nodular lesions in both lungs, a lesion in the lower lobe of his left lung, not present 6 months ago, peritoneal carcinomatosis, and several para-aortic lymphadenopathies were detected by imaging studies. A radioactive iodine uptake scan, positron emission tomography/computed tomography scan, and transbronchial biopsy of the lesion in the lung revealed concurrent squamous cell carcinoma of the lung and pulmonary metastasis of papillary thyroid carcinoma. After consultation with an oncologist, our patient received 6 months of chemotherapy; however, he died 8 months after presentation. CONCLUSIONS Physicians should be aware of the possibility of the emergence of primary malignancies in patients with a history of papillary thyroid carcinoma, especially lung cancer as it is a common site of papillary thyroid carcinoma metastases. Using appropriate diagnostic evaluations in order to choose the best therapeutic option is of utmost importance.
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Affiliation(s)
- Arya Aminorroaya
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Universal Scientific Education and Research Network, Tehran, Iran
| | - Mohsen Khoshniatnikoo
- Endocrinology & Metabolism Research Center, Endocrinology & Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Dr. Shariati Hospital, Jalal Al Ahmad Highway, Tehran, 1411713137, Iran
| | - Hossein Farrokhpour
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Jamshid Vafaeimanesh
- Gastroenterology & Hepatology Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Mohammad Bagherzadeh
- Endocrinology & Metabolism Research Center, Endocrinology & Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Dr. Shariati Hospital, Jalal Al Ahmad Highway, Tehran, 1411713137, Iran. .,Clinical Research Development Center, Qom University of Medical Sciences, Qom, Iran.
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Yang YH, Deng Q, Yang TB, Gui Y, Zhang YX, Liu JB, Deng Q, Liu WF, Sun JJ. A case report of cholangiocarcinoma combined with moderately differentiated gastric adenocarcinoma. Medicine (Baltimore) 2019; 98:e16332. [PMID: 31348232 PMCID: PMC6709107 DOI: 10.1097/md.0000000000016332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
RATIONALE Multiple primary carcinoma (MPM) refers to simultaneous or successive occurrence of ≥2 types of primary malignant tumors in a single organ or in different organs of the same individual. It is rarely seen in clinical practice. Among the various types of MPM, hilar cholangiocarcinoma combined with gastric cancer is extremely rare. PATIENT CONCERNS The patient was a 61-year-old man who was admitted to our hospital due to upper abdominal discomfort and yellow-stained skin mucosa for 9 days. DIAGNOSES Preoperative diagnosis: Considering the typical preoperative painless jaundice as well as his clinical imaging report, the patient received the following preoperative diagnosis: obstructive jaundice, type IV hilar cholangiocarcinoma based on Bismuth-Corlette classification, and no intrahepatic distant metastasis. Intraoperative diagnosis: The results of intraoperative snap freezing and laboratory examination indicated gastric adenocarcinoma. Therefore, the patient received an intraoperative diagnosis of obstructive jaundice, hilar cholangiocarcinoma, and gastric cancer. Postoperative pathological diagnosis: Postoperative pathological examination of the gastric lesion revealed the following results: ulcerative, moderately differentiated gastric adenocarcinoma and intestinal type in the Lauren classification of stomach cancer; moderately differentiated adenocarcinoma of the bile duct. INTERVENTIONS Surgical resection operation was carried out and the patient received chemotherapy after operation. But we could not strictly follow the relevant clinical guidelines to perform standardized operations and provide comprehensive treatment because of his economic situation, psychological factors, and the current medical environment in China. OUTCOMES The patient did not receive standardized postoperative therapy. Although he lived and worked normally for 8 months after the operation, he died 10 months after surgery. LESSONS This report reminds us to pay close attention to the likelihood of MPM and other low-incidence diseases. The physicians and imaging clinicians should explore all clinical possibilities to avoid misdiagnosis of this rare disease and formulate effective treatment plans to maximize the therapeutic benefits for the patient.
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Affiliation(s)
| | | | | | - Yang Gui
- Department of Hepatobiliary Surgery
| | | | - Jiang-Bo Liu
- Department of Breast Surgery, First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology
| | - Qian Deng
- Faculty of Pharmaceutical Sciences, Luoyang Central Hospital affiliated to Zhengzhou University, Luoyang, China
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Jiang Y, Miao Z, Wang J, Chen J, Lv Y, Xing D, Wang X, Wang Y, Cao Z, Zhao Z. Clinical characteristics and prognosis associated with multiple primary malignant tumors in non-Hodgkin lymphoma patients. TUMORI JOURNAL 2019; 105:474-482. [PMID: 30945608 DOI: 10.1177/0300891619839475] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Patients with non-Hodgkin lymphoma (NHL) occasionally present with multiple primary malignant tumors (MPMTs). This study aimed to determine the clinical characteristics, survival, and risk factors of these patients. METHODS The median follow-up of 92 patients was 13.5 months (range 0.3-72). Overall, 21 patients had synchronous MPMTs and 71 had metachronous MPMTs. We classified patients in the latter group into metachronous first group (n=27) and metachronous second group (n=44). RESULTS Diffuse large B-cell lymphoma was the most frequent histologic lymphoma type. The digestive system was the commonest site affected by the solid cancer. The 1- and 2-year survival rates were 86.5% and 70.5%, respectively. The overall survival (OS) rates were 67.9% and 36.2% at 2 and 3 years, respectively, in the metachronous first group; 73.8% and 73.8%, respectively, in the metachronous second group; and 68.1% and 56.7%, respectively, in the synchronous tumor group. There was no difference in the survival rate among the 3 groups before 2 years, but after 2 years, a shorter OS rate was observed in the metachronous first group than in the metachronous second group and synchronous tumor group. For all patients, age >60 years, male sex, and ⩾3 involved nodal sites were considered independent prognostic factors associated with survival. CONCLUSIONS OS time was shorter in patients with NHL who developed a second tumor than in those who were diagnosed with solid cancer synchronously and second neoplasm after previous solid tumors. Long-term follow-up and effective treatment should be provided to these patients.
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Affiliation(s)
- Yanan Jiang
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Zhaoyi Miao
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Jinhuan Wang
- Department of Oncology, Second Hospital of Tianjin Medical University, Institute of Urology Tianjin, China
| | - Jing Chen
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Yangyang Lv
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Donghui Xing
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Xiaofang Wang
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Yafei Wang
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Zeng Cao
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Zhigang Zhao
- Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
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Incidence and Mortality Rates of Second Pancreatic Cancer Among Survivors of Digestive Cancers: A Nationwide Population-Based Study. Pancreas 2019; 48:412-419. [PMID: 30768577 DOI: 10.1097/mpa.0000000000001254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES We analyzed the incidence and mortality rates of second pancreatic ductal adenocarcinoma (PDAC) among survivors of digestive cancers in South Korea. METHODS We evaluated data from the Korea National Health Insurance to identify individuals with digestive cancers in 2005 to 2015. The standardized incidence ratios (SIRs) of second PDACs and survival rates were evaluated. RESULTS Among 772,534 patients with first digestive cancers, 1696 (0.22%) developed second PDACs. The incidence of second PDACs increased until 10 years since the first cancer diagnosis. Patients with biliary tract cancers (BTCs) showed a higher incidence of second PDACs than did those with gastrointestinal cancers or hepatocellular carcinoma. In ages 20 to 49 years, SIRs (95% confidence interval) were higher in survivors of hepatocellular carcinoma (3.08; 1.04-3.08), gastric cancer (3.40; 1.90-3.40), colorectal cancer (5.00; 2.75-5.00), gallbladder cancer (58.52; 11.81-58.52), intrahepatic cholangiocarcinoma (86.99; 1.73-86.99), extrahepatic cholangiocarcinoma (89.41; 27.42-89.41), and ampulla of Vater cancer (156.78; 48.08-156.78). In ages 50 to 64 years, colorectal cancer (1.42; 1.04-1.42), gastric cancer (1.66; 1.29-1.66), and BTCs revealed higher SIRs. In ages more than 65 years, SIR was increased only in BTCs. Second PDACs revealed a more favorable prognosis than first PDACs. CONCLUSIONS Careful surveillance for second PDACs after curative treatment of BTCs and colorectal cancers should be considered.
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Li J, Zou Y, Wang B, Meng X, Sun X. Concomitant occurrence of primary renal non-Hodgkin lymphoma and a colon cancer: A rare case report. Medicine (Baltimore) 2019; 98:e14802. [PMID: 30855498 PMCID: PMC6417636 DOI: 10.1097/md.0000000000014802] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
RATIONALE Primary renal lymphoma (PRL) is a rare malignancy due to the absence of lymphatic tissues in the kidney, and patients with PRL have been reported to have a poor prognosis due to its rapid invasiveness and limited treatment strategies. Colon cancer is the third most common cancer, and has a high mortality rate. Both malignant diseases predominantly affected elderly men; however, a case with concomitant occurrence of the 2 cancers is extremely rare. PATIENT CONCERNS A 78-year-old male patient with abdominal pain came to our hospital. Computed tomography (CT) indicated malignant masses in the left kidney, left adrenal gland, and the lower part of the descending colon. DIAGNOSES PRL and colon cancer were diagnosed based on pathological examinations. INTERVENTIONS The patient was treated with laparoscopic radical nephrectomy and laparoscopic radical resection of colon cancer. OUTCOMES The patient was then transferred to the intensive care unit (ICU) because of poor condition after surgery. He died 3 months after discharge without receiving any other treatment. LESSONS It is worth thinking about whether surgery was reasonable for elderly patients with double malignancies, or palliative treatment to improve the quality of life was more meaningful. This case also contributes to the understanding of the 2 malignancies and highlights the need to pay more attention to patients with multiple primary malignant neoplasms (MPMNs), explore genetic features, and investigate treatments with more survival benefits.
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Affiliation(s)
- Ji Li
- Department of Gastroenterology
| | | | - Bin Wang
- Department of Infectious Disease, the First Hospital of Jilin University, Changchun, Jilin, China
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Yoshikawa T, Abe T, Amano H, Hanada K, Minami T, Kobayashi T, Yonehara S, Nakahara M, Ohdan H, Noriyuki T. Metachronous triple cancer associated with Peutz-Jeghers syndrome treated with curative surgery: a case report. Surg Case Rep 2018; 4:84. [PMID: 30069736 PMCID: PMC6070452 DOI: 10.1186/s40792-018-0492-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 07/23/2018] [Indexed: 12/17/2022] Open
Abstract
Background Peutz–Jeghers syndrome (PJS) is an autosomal dominant disorder characterized by mucocutaneous pigmentation and hamartomatous gastrointestinal polyposis. It is well known that individuals with PJS are at an increased risk of cancer in a variety of organs. Case presentation Here, we present a patient with PJS who achieved long-term survival by undergoing repeat curative surgery for metachronous triple cancer. Her medical history included hilar cholangiocarcinoma and cervical carcinoma; curative surgery was performed for both conditions. On annual follow-up, the level of carcinoembryonic antigen was elevated at 6.9 ng/ml. Enhanced computed tomography revealed a cystic tumor consisting of mural nodules at the pancreatic head; the maximal diameter was 15 mm. Magnetic resonance imaging clearly demonstrated the tumor with low intensity on T1-weighted images and high intensity on T2-weighted images. Endoscopic ultrasound sonography showed a high echoic tumor at the pancreatic head, which was confirmed as adenocarcinoma by fine-needle aspiration biopsy. The preoperative diagnosis was intraductal papillary mucinous carcinoma (IPMC; T1N0M0, stage IA). Subtotal stomach-preserving pancreaticoduodenectomy was performed and the final diagnosis was IPMC, stage 0 (TisN0M0). Conclusions Aggressive surgery for metachronous triple cancer resulted in good long-term prognosis. Continuous and systematic follow-up would allow the detection of malignancy at an early stage and make treatment with curative surgery possible.
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Affiliation(s)
- Toru Yoshikawa
- Department of Surgery, Onomichi General Hospital, 1-10-23, Onomichi, Hiroshima, 722-8508, Japan
| | - Tomoyuki Abe
- Department of Surgery, Onomichi General Hospital, 1-10-23, Onomichi, Hiroshima, 722-8508, Japan.
| | - Hironobu Amano
- Department of Surgery, Onomichi General Hospital, 1-10-23, Onomichi, Hiroshima, 722-8508, Japan.,Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Keiji Hanada
- Department of Gastroenterology, Onomichi General Hospital, Onomichi, Hiroshima, Japan
| | - Tomoyuki Minami
- Department of Gastroenterology, Onomichi General Hospital, Onomichi, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shuji Yonehara
- Department of Pathology, Onomichi General Hospital, Onomichi, Hiroshima, Japan
| | - Masahiro Nakahara
- Department of Surgery, Onomichi General Hospital, 1-10-23, Onomichi, Hiroshima, 722-8508, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Toshio Noriyuki
- Department of Surgery, Onomichi General Hospital, 1-10-23, Onomichi, Hiroshima, 722-8508, Japan.,Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Zhai C, Cai Y, Lou F, Liu Z, Xie J, Zhou X, Wang Z, Fang Y, Pan H, Han W. Multiple Primary Malignant Tumors - A Clinical Analysis of 15,321 Patients with Malignancies at a Single Center in China. J Cancer 2018; 9:2795-2801. [PMID: 30123347 PMCID: PMC6096360 DOI: 10.7150/jca.25482] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 06/09/2018] [Indexed: 12/25/2022] Open
Abstract
Background: Multiple primary malignant tumors (MPMTs) are defined as two or more histologically distinct malignancies in one individual, standard treatments for MPMTs are not well established, we aimed to clinical analyze the factors influence the treatment efficacy of MPMTs. Methods: This study retrospectively analyzed 15,321 malignant tumor patients at the Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, China, between March 2006 and June 2016. The survival analysis was performed with SPSS version 22.0 (SPSS Inc., Chicago, IL, USA) with Kaplan-Meier methodology. Results: The prevalence of MPMTs in our study was 1.09% (167/15321), with a male to female ratio of 2.34:1. Specifically, 98 patients harbored synchronous MPMTs, and 69 patients harbored metachronous MPMTs. The most common cancer pairs were digestive-digestive tumor (43 patients, 25.75%), digestive-lung cancer (32 patients, 19.16%), and head & neck-digestive tumor (11 patients, 6.59%). Among patients with synchronous and metachronous first primary cancers, 65.86% received surgery. 33.33% (27/81) of the patients with synchronous MPMTs received simultaneous resection. Of the 69 patients with metachronous MPMTs, 31.88% (22/69) were treated with surgery alone, 62.32% (43/69) received chemotherapy and/or radiotherapy for the first primary tumor, and 44.93% (31/69) received surgery for the other primary tumor. 98.20% (164/167) of patients with MPMTs were effectively followed up, the overall 2- and 5-year survival rates were 54.3% and 31.4%, respectively, with a median survival time of 28.0 months. Conclusions: The early diagnosis of rare MPMTs should not be neglected in patients not only when treated for a primary malignancy but also during long-term follow-up. Effective treatment for MPMTs may yield promising curative effect and warrants further investigation.
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Affiliation(s)
- Chongya Zhai
- Department of Medical Oncology, Xiasha Campus, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yulan Cai
- Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Fang Lou
- Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Zhen Liu
- Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jiansheng Xie
- Laboratory of Cancer Biology, Institute of Clinical Science, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaoyun Zhou
- Department of Medical Oncology, Xiasha Campus, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Zhanggui Wang
- Department of Radiotherapy, The Second People's Hospital of Anhui Province, Hefei, Anhui, China
| | - Yong Fang
- Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Hongming Pan
- Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.,Laboratory of Cancer Biology, Institute of Clinical Science, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Weidong Han
- Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.,Laboratory of Cancer Biology, Institute of Clinical Science, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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Sapalidis K, Schizas N, Lazopoulos A, Kamparoudi P, Paliouras D, Sardeli C, Konstantinou F, Chatzinikolaou F, Sarafis P, Zarogoulidis P, Kougioumtzi I, Katsikogiannis N, Karapantzos I, Karapantzou C, Laskou S, Koulouris C, Mantalobas S, Giannakidis D, Kesisoglou I, Barbetakis N. Multiple metachronous and synchronous malignancies with lung and thorax involvement. Report of two cases. Respir Med Case Rep 2018; 24:5-7. [PMID: 29977745 PMCID: PMC6010593 DOI: 10.1016/j.rmcr.2018.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 03/12/2018] [Accepted: 03/12/2018] [Indexed: 01/30/2023] Open
Abstract
Multiple primary malignant neoplasms (MPMN) is an uncommon phenomenon, while the diagnosis of such conditions is very significant. Considering that the strategy of the treatment is determined by the histological type of the tumor, practitioners should be alert in order to avoid malpractices in cases of multiple metachronous or synchronous malignancies. In this article we report two rare cases of MPMN. The first patient suffered from three metachronous malignant neoplasms, specifically tonsillar, lung and breast cancer, while the second patient was diagnosed with four synchronous and metachronous malignant tumors, including renal and lung cancer, basaloid carcinoma and melanoma. Such cases are extremely rare in the clinical practice and poorly described in the literature.
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Affiliation(s)
- Konstantinos Sapalidis
- 3rd Department of Surgery, “AHEPA” University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Nikos Schizas
- Thoracic Surgery Department, “Theagenio” Cancer Hospital, Thessaloniki, Greece
| | - Achileas Lazopoulos
- Thoracic Surgery Department, “Theagenio” Cancer Hospital, Thessaloniki, Greece
| | - Parthena Kamparoudi
- Thoracic Surgery Department, “Theagenio” Cancer Hospital, Thessaloniki, Greece
| | - Dimitris Paliouras
- Thoracic Surgery Department, “Theagenio” Cancer Hospital, Thessaloniki, Greece
| | - Chrysa Sardeli
- 3rd Department of Surgery, “AHEPA” University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Fotis Konstantinou
- 3rd Department of Surgery, “AHEPA” University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | | | - Pavlos Sarafis
- Nursing Department, Cyprus University of Technology, Cyprus
| | - Paul Zarogoulidis
- Pulmonary Department-Oncology Unit, “Theagenio” Cancer Hospital, Thessaloniki, Greece
| | - Ioanna Kougioumtzi
- Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Nikolaos Katsikogiannis
- Surgery Department (NHS), University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Ilias Karapantzos
- Ear,Nose and Throat Department, “Saint Luke” Private Hospital, Panorama, Thessaloniki, Greece
| | - Chrysa Karapantzou
- Ear,Nose and Throat Department, “Saint Luke” Private Hospital, Panorama, Thessaloniki, Greece
| | - Stella Laskou
- 3rd Department of Surgery, “AHEPA” University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Charilaos Koulouris
- 3rd Department of Surgery, “AHEPA” University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Stylianos Mantalobas
- 3rd Department of Surgery, “AHEPA” University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Dimitris Giannakidis
- 3rd Department of Surgery, “AHEPA” University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Isaak Kesisoglou
- 3rd Department of Surgery, “AHEPA” University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Nikos Barbetakis
- Thoracic Surgery Department, “Theagenio” Cancer Hospital, Thessaloniki, Greece
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35
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Jiang W, Shen Y, Ding Y, Ye C, Zheng Y, Zhao P, Liu L, Tong Z, Zhou L, Sun S, Zhang X, Teng L, Timko MP, Fan L, Fang W. A naive Bayes algorithm for tissue origin diagnosis (TOD-Bayes) of synchronous multifocal tumors in the hepatobiliary and pancreatic system. Int J Cancer 2018; 142:357-368. [PMID: 28921531 DOI: 10.1002/ijc.31054] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 08/24/2017] [Accepted: 09/04/2017] [Indexed: 12/30/2022]
Abstract
Synchronous multifocal tumors are common in the hepatobiliary and pancreatic system but because of similarities in their histological features, oncologists have difficulty in identifying their precise tissue clonal origin through routine histopathological methods. To address this problem and assist in more precise diagnosis, we developed a computational approach for tissue origin diagnosis based on naive Bayes algorithm (TOD-Bayes) using ubiquitous RNA-Seq data. Massive tissue-specific RNA-Seq data sets were first obtained from The Cancer Genome Atlas (TCGA) and ∼1,000 feature genes were used to train and validate the TOD-Bayes algorithm. The accuracy of the model was >95% based on tenfold cross validation by the data from TCGA. A total of 18 clinical cancer samples (including six negative controls) with definitive tissue origin were subsequently used for external validation and 17 of the 18 samples were classified correctly in our study (94.4%). Furthermore, we included as cases studies seven tumor samples, taken from two individuals who suffered from synchronous multifocal tumors across tissues, where the efforts to make a definitive primary cancer diagnosis by traditional diagnostic methods had failed. Using our TOD-Bayes analysis, the two clinical test cases were successfully diagnosed as pancreatic cancer (PC) and cholangiocarcinoma (CC), respectively, in agreement with their clinical outcomes. Based on our findings, we believe that the TOD-Bayes algorithm is a powerful novel methodology to accurately identify the tissue origin of synchronous multifocal tumors of unknown primary cancers using RNA-Seq data and an important step toward more precision-based medicine in cancer diagnosis and treatment.
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Affiliation(s)
- Weiqin Jiang
- Cancer Biotherapy Center, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yifei Shen
- Institute of Bioinformatics & IBM Bio-computational Laboratory, Zhejiang University, Hangzhou, China
- Research Center for Air Pollution and Health, Zhejiang University, Hangzhou, China
| | - Yongfeng Ding
- Department of Surgical Oncology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chuyu Ye
- Institute of Bioinformatics & IBM Bio-computational Laboratory, Zhejiang University, Hangzhou, China
- Research Center for Air Pollution and Health, Zhejiang University, Hangzhou, China
| | - Yi Zheng
- Cancer Biotherapy Center, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Peng Zhao
- Cancer Biotherapy Center, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Precision Diagnosis & Treatment for Hepatobiliary & Pancreatic Tumor of Zhejiang Province, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lulu Liu
- Cancer Biotherapy Center, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhou Tong
- Cancer Biotherapy Center, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Linfu Zhou
- Medical Biotechnology Laboratory, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shuo Sun
- Institute of Bioinformatics & IBM Bio-computational Laboratory, Zhejiang University, Hangzhou, China
- Research Center for Air Pollution and Health, Zhejiang University, Hangzhou, China
| | - Xingchen Zhang
- Institute of Bioinformatics & IBM Bio-computational Laboratory, Zhejiang University, Hangzhou, China
- Research Center for Air Pollution and Health, Zhejiang University, Hangzhou, China
| | - Lisong Teng
- Department of Surgical Oncology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Precision Diagnosis & Treatment for Hepatobiliary & Pancreatic Tumor of Zhejiang Province, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Michael P Timko
- Departments of Biology and Public Health Science, University of Virginia, Charlottesville, VA, 22904
| | - Longjiang Fan
- Institute of Bioinformatics & IBM Bio-computational Laboratory, Zhejiang University, Hangzhou, China
- Research Center for Air Pollution and Health, Zhejiang University, Hangzhou, China
| | - Weijia Fang
- Cancer Biotherapy Center, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Key Laboratory of Precision Diagnosis & Treatment for Hepatobiliary & Pancreatic Tumor of Zhejiang Province, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Alharbi A, Aboasamh G, Shafik Y. Appendicular and breast cancers in an old lady: a case report. J Surg Case Rep 2017; 2017:rjx251. [PMID: 29308181 PMCID: PMC5751079 DOI: 10.1093/jscr/rjx251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 11/15/2017] [Accepted: 12/08/2017] [Indexed: 01/30/2023] Open
Abstract
The presence of two or more malignant tumors of different histological entities in an individual is referred to as multiple primary malignant neoplasms (MPMN). These are becoming more frequently encountered and reported in clinical practice nowadays. Majority of MPMN are diagnosed in elderly, where senility might alter the management plan. Despite the increased reporting of MPMN in the literature, only a few elaborated on the management of such cases. Also, the combination of synchronous primary appendicular and breast cancers—to our knowledge—has never been reported. Here we present the first report of an appendicular adenocarcinoma synchronously presenting along with invasive ductal carcinoma of the breast. We highlight the diagnostic essentials and the multidisciplinary management approach including surgical excision and adjuvant therapy.
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Affiliation(s)
- Ahlam Alharbi
- General Surgery, King Abdul Aziz Medical City, Jeddah 21423, Saudi Arabia
| | - Ghaleb Aboasamh
- General Surgery, King Abdul Aziz Medical City, Jeddah 21423, Saudi Arabia
| | - Yasmine Shafik
- General Surgery, King Abdul Aziz Medical City, Jeddah 21423, Saudi Arabia
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37
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Cheng C, Zhou J, Shao X. Lung adenocarcinoma and pulmonary metastases coexist in a patient with papillary thyroid carcinoma: A case report. Medicine (Baltimore) 2017; 96:e9078. [PMID: 29245323 PMCID: PMC5728938 DOI: 10.1097/md.0000000000009078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
RATIONALE Multiple primary malignant tumors (MPMTs) are defined as 2 or more independent primary malignancies of different histologies/origins in the same individual. Although the incidence of MPMTs is being increasing, second primary cancer (SPC) is still rare and difficult to distinguish from metastasis. Here, we present a case of thyroid carcinoma with lung metastasis and primary lung cancer. PATIENTS CONCERNS The patient was a 66-year-old man diagnosed of papillary thyroid carcinoma (PTC) with lymph nodes, lung, and skeletons metastases. One of the pulmonary nodules had contrary manifestations, such as, noniodine avid, high uptake of F-fluorodexyglucose (F-FDG) and progress after iodine-131 radioiodine therapy. INTERVENTIONS CT guided biopsy and I-125 seed brachytherapy of nodule in right upper lobe were performed. DIAGNOSIS The patient was diagnosed of PTC with lymph nodes, lung, and skeletons metastases, accompanied by primary lung adenocarcinoma. OUTCOMES After 2 years of follow-up, nodules of inferior lobes almost disappeared and the nodule of right upper lobe shrank to only 0.7 cm. LESSONS Physicians should be aware of SPC in clinical work, and improve the early diagnosis rate with a variety of examination methods and select the best treatment to improve the prognosis of patients.
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Affiliation(s)
- Changhai Cheng
- Department of Radiation Oncology, the Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Jinxin Zhou
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaonan Shao
- Department of Nuclear Medicine, the Third Affiliated Hospital of Soochow University, Changzhou, China
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38
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Khade P, Devarakonda S. Coexisting multiple myeloma, lymphoma, and non-small cell lung cancer: a case report and review of the literature. Int Med Case Rep J 2017; 10:373-376. [PMID: 29184450 PMCID: PMC5685092 DOI: 10.2147/imcrj.s147266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Multiple myeloma is a plasma cell dyscrasia characterized by neoplastic proliferation of plasma cells, producing a monoclonal immunoglobulin. Small lymphocytic lymphoma (SLL) is a neoplasm consisting of monoclonal B-cell lymphocyte proliferation. We present an extremely rare case of coexisting multiple myeloma, SLL, and squamous cell carcinoma of the lung in a 74-year-old female patient. She initially presented with a midline mass with pain in the lumbar area. Debulking surgery was performed, and pathology showed plasmacytoma. Further evaluation revealed coexistent IgG kappa myeloma. Imaging revealed extensive abdominal lymphadenopathy, and mesenteric lymph node biopsy confirmed the presence of SLL. The patient was also found to have a mass in the left lower lobe of the lung; biopsy showed squamous cell carcinoma. This patient was treated with lenalidomide and dexamethasone for multiple myeloma, and stereotactic body radiotherapy for limited stage lung cancer. Due to the more indolent course of SLL, watchful waiting was applied.
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Affiliation(s)
- Parth Khade
- Department of Internal Medicine, Louisiana State University Health, Shreveport, LA, USA
| | - Srinivas Devarakonda
- Department of Internal Medicine, Louisiana State University Health, Shreveport, LA, USA
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Nishiwaki S, Okuno S, Suzuki K, Kurahashi S, Sugiura I. Impact of Synchronous Multiple Primary Malignant Tumors on Newly Diagnosed Hematological Malignancies. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2017; 17:e79-e85. [PMID: 29033300 DOI: 10.1016/j.clml.2017.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 09/11/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Hematological malignancies are occasionally observed with synchronous multiple primary malignant tumors (sMPMTs) at diagnosis. We aimed to clarify the impact of sMPMTs on newly diagnosed hematological malignancies and determine the optimal treatment strategies. PATIENTS AND METHODS We analyzed the outcomes of 649 patients with hematological malignancies, including 19 patients with sMPMTs (2.9%), and compared the outcomes between patients with and without sMPMTs. RESULTS The overall survival (OS) and disease-free survival (DFS) rates for patients with sMPMTs were 77% and 70%, respectively, at 2 years; these rates were not statistically different from those for patients without sMPMTs (P = .17 and P = .64, respectively). Multivariate analysis showed that the presence of sMPMTs was not a significant prognostic factor for OS, DFS, or relapse (hazard ratio [HR] 1.48, 95% confidence interval [CI] 0.65-3.38, P = .35; HR 0.97, 95% CI 0.46-2.10, P = .97; and HR 0.79, 95% CI 0.29-2.14, P = .65). In patients with sMPMTs, the order of treatment was not a significant prognostic factor. However, discontinuation of treatment was a marginally favorable factor and might reflect a selection bias. CONCLUSION The presence of sMPMTs was not a significant risk factor for patients with newly diagnosed hematological malignancies. It is important to provide adequate treatment for both hematological malignancies and solid tumors at the physician's discretion.
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Affiliation(s)
- Satoshi Nishiwaki
- Division of Hematology and Oncology, Toyohashi Municipal Hospital, Toyohashi, Japan; Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan.
| | - Shingo Okuno
- Division of Hematology and Oncology, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Kotaro Suzuki
- Division of Hematology and Oncology, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Shingo Kurahashi
- Division of Hematology and Oncology, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Isamu Sugiura
- Division of Hematology and Oncology, Toyohashi Municipal Hospital, Toyohashi, Japan
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40
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Liu Z, Li S, Bai O. Swollen lymph nodes may not be clinical manifestations of chronic myeloid leukemia: case report and revision of literature. Ther Clin Risk Manag 2017; 13:1159-1162. [PMID: 28919770 PMCID: PMC5592907 DOI: 10.2147/tcrm.s147056] [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: 11/23/2022] Open
Abstract
We present here the case of a 33-year-old Chinese female patient with synchronous double primary malignant tumors (chronic myeloid leukemia [CML] and classic Hodgkin lymphoma). This patient was admitted to our hospital because of bilateral cervical lymph node enlargement and recurrent fever for 2 weeks. The complete blood cell count revealed white blood cell counts of 18.2×109/L, hemoglobin of 9.6 g/dL, and platelet counts of 1,547×109/L. Chromosome karyotype analysis demonstrated that t(9;22)(q34;q11) was positive in all 20 cells examined. Reverse transcription polymerase chain reaction showed that the ratio of BCR/ABL1 to ABL was 45.3%. This patient was diagnosed with CML. After definite diagnosis, this patient regularly received imatinib therapy. Three months later, although complete blood count was normal, swollen lymph nodes further increased. Swollen lymph node biopsy was performed to evaluate the nature of these swollen lymph nodes, and results displayed that Hodgkin and Reed-Sternberg cells, CD30, CD15, and Epstein-Barr virus-encoded RNA was positive. In conclusion, this patient was diagnosed with synchronous double primary malignant tumors. This case report suggests that swollen lymph nodes may be due to lymphoma, rather than as a clinical manifestation of CML.
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Affiliation(s)
- Zhihe Liu
- Department of Hematology, The First Hospital of Jilin University, Changchun
| | - Siyun Li
- Department of Pediatrics, Women and Children's hospital of Qingdao university, Qingdao, People's Republic of China
| | - Ou Bai
- Department of Hematology, The First Hospital of Jilin University, Changchun
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Lv M, Zhang X, Shen Y, Wang F, Yang J, Wang B, Chen Z, Li P, Zhang X, Li S, Yang J. Clinical analysis and prognosis of synchronous and metachronous multiple primary malignant tumors. Medicine (Baltimore) 2017; 96:e6799. [PMID: 28445321 PMCID: PMC5413286 DOI: 10.1097/md.0000000000006799] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The aim of this study was to determine the clinical features, treatment factors, and prognosis of patients with multiple primary malignant tumors (MPMTs). In total, 161 patients with MPMTs at our hospital (The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China) were analyzed in this study. We found that among 161 patients with MPMTs, 78 (48.4%) patients had synchronous tumors and 83 (51.6%) patients had metachronous tumors. Most clinical and pathological features were similar in both groups. Most patients with MPMTs were men and older patients (>50 years old), and adenocarcinoma was the most frequent pathology type. The most frequent location of all MPMTs was the digestive system. The leading tumor association was between digestive-digestive tumors, also. However, patients with synchronous tumors and MPMTs of the digestive system showed a shorter survival time. In the metachronous cancer group, the median interval time was 60 months, and a short interval time (≤60 months) was associated with a shorter survival time. In addition, survival time was increased in the younger age group (≤50 years old) and in patients who accepted surgery-based comprehensive therapy. However, only interval time (≤60 months) was an independent prognostic factor associated with survival for the metachronous cancer group. Therefore, careful surveillance and follow-up are especially important in these patients.
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Affiliation(s)
- Meng Lv
- Department of Oncology, The First Affiliated Hospital of Xian Jiaotong University, Xi’an
| | - Xiao Zhang
- Department of Medical Oncology, Xianyang Center Hospital, Xianyang, Shaanxi, PR China
| | - Yanwei Shen
- Department of Oncology, The First Affiliated Hospital of Xian Jiaotong University, Xi’an
| | - Fan Wang
- Department of Oncology, The First Affiliated Hospital of Xian Jiaotong University, Xi’an
| | - Jiao Yang
- Department of Oncology, The First Affiliated Hospital of Xian Jiaotong University, Xi’an
| | - Biyuan Wang
- Department of Oncology, The First Affiliated Hospital of Xian Jiaotong University, Xi’an
| | - Zheling Chen
- Department of Oncology, The First Affiliated Hospital of Xian Jiaotong University, Xi’an
| | - Pan Li
- Department of Oncology, The First Affiliated Hospital of Xian Jiaotong University, Xi’an
| | - Xiaoman Zhang
- Department of Oncology, The First Affiliated Hospital of Xian Jiaotong University, Xi’an
| | - Shuting Li
- Department of Oncology, The First Affiliated Hospital of Xian Jiaotong University, Xi’an
| | - Jin Yang
- Department of Oncology, The First Affiliated Hospital of Xian Jiaotong University, Xi’an
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Jiang W, Ding Y, Shen Y, Fan L, Zhou L, Li Z, Zheng Y, Zhao P, Liu L, Tong Z, Fang W, Wang W. Identifying the clonal origin of synchronous multifocal tumors in the hepatobiliary and pancreatic system using multi-omic platforms. Oncotarget 2017; 8:5016-5025. [PMID: 28008139 PMCID: PMC5354888 DOI: 10.18632/oncotarget.14018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 12/07/2016] [Indexed: 01/06/2023] Open
Abstract
Synchronous multifocal tumors often pose a diagnostic challenge for oncologists. The purpose of this study was to determine the clonal origin and metastatic relationship of synchronous multifocal tumors in the hepatobiliary and pancreatic system using multi-omic platforms. DNA samples were extracted from three masses harvested from a 50-year-old Han Chinese male patient who suffered from synchronous multifocal tumors in the pancreatic tail, upper biliary duct, and omentum at the time of diagnosis. The clonal origin of these samples was tested using two platforms: next-generation sequencing (NGS) of 390 key genes harboring cancer-relevant actionable mutations and whole-genome copy number variation (CNV) chip analysis. The NGS approach revealed high mutational concordance, and the gene CNV profiles were similar between lesions. Whole-genome CNVs for the three samples were further investigated using an Affymetrix chip. Using matched CNV chip data from The Cancer Genome Atlas (TCGA), we developed a computational model that generated tissue-specific CNV signatures for hepatocellular carcinoma, pancreatic carcinoma, and cholangiocarcinoma to accurately identify the origin of the tumor samples. After adding the patient's CNV chip data to the model, all three samples were clustered into the pancreatic cancer branch. Both our NGS and CNV chip analyses suggested that clinically diagnosed synchronous pancreatic cancer and cholangiocarcinoma originated from the same cell population in the pancreas in our patient. This study highlights the use of genomic tools to infer the origin of synchronous multifocal tumors, which could help to improve the accuracy of cancer diagnosis.
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Affiliation(s)
- Weiqin Jiang
- Cancer Biotherapy Center, First Affiliated Hospital, Zhejiang University, China
| | - Yongfeng Ding
- Department of Surgical Oncology, First Affiliated Hospital, Zhejiang University, China
| | - Yifei Shen
- Institute of Bioinformatics & Research Center for Air Pollution and Health, Zhejiang University, China
| | - Longjiang Fan
- Institute of Bioinformatics & Research Center for Air Pollution and Health, Zhejiang University, China
| | - Linfu Zhou
- Medical Biotechnology Laboratory, Zhejiang University, China
| | - Zhi Li
- Department of Radiology, First Affiliated Hospital, Zhejiang University, China
| | - Yi Zheng
- Cancer Biotherapy Center, First Affiliated Hospital, Zhejiang University, China
| | - Peng Zhao
- Cancer Biotherapy Center, First Affiliated Hospital, Zhejiang University, China
| | - Lulu Liu
- Cancer Biotherapy Center, First Affiliated Hospital, Zhejiang University, China
| | - Zhou Tong
- Cancer Biotherapy Center, First Affiliated Hospital, Zhejiang University, China
| | - Weijia Fang
- Cancer Biotherapy Center, First Affiliated Hospital, Zhejiang University, China
| | - Weilin Wang
- Key Laboratory of Precision Diagnosis & Treatment for Hepatobiliary & Pancreatic Tumor, First Affiliated Hospital, Zhejiang University, China
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, China
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Xu W, Liao W, Ge P, Ren J, Xu H, Yang H, Sang X, Lu X, Mao Y. Multiple Primary Malignancies in Patients With Hepatocellular Carcinoma: A Largest Series With 26-Year Follow-Up. Medicine (Baltimore) 2016; 95:e3491. [PMID: 27124050 PMCID: PMC4998713 DOI: 10.1097/md.0000000000003491] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Multiple primary malignancies (MPMs) are defined as 2 or more malignancies without subordinate relationship detected in different organs of an individual patient. Reports addressing MPM patients with hepatocellular carcinoma (HCC) are rare. We perform a 26-year follow-up study to investigate characteristics and prognosis of MPM patients associated with HCC due to the scarcity of relative researches.We retrospectively analyzed records of 40 patients who were diagnosed with MPM including HCC at the Departments of Surgery at Peking Union Medical College Hospital during 1989 to 2010. Their clinical characteristics and postoperative survival were compared with those of 448 patients who had HCC only during the study period.Among the 40 MPM patients, 11 were diagnosed synchronously and 29 metachronously. The most common extra-hepatic malignancies were lung cancer (15%), colorectal (12.5%), and thyroid carcinoma (12.5%). MPM patients had a negative hepatitis B virus infection rate (P = 0.013) and lower median alfa-fetoprotein (AFP) level (P = 0.001). Post-operative 1-, 3-, and 5-year overall survival (OS) rates for MPM patients were 82.5%, 64.5%, and 38.6% respectively, and showed no significant difference with those of HCC-only patients (84.7%, 54.2%, and 38.3% P = 0.726). During follow-up, 24 MPM patients died, including 17 (70.8%) who died of HCC-related causes. In univariate analysis, synchronous diagnosis, higher gamma glutamyltransferase (GGT) and/or AFP levels, tumor >5 cm and vascular invasion were significantly associated with shorter OS, but only tumor size was an independent OS factor in Cox modeling analysis.HCC should be considered as a potential second primary for all cancer survivors. Most MPM patients died of HCC-related causes and showed no significant difference in OS compared with HCC-only patients. Tumor size of HCC, rather than MPMs itself, was the only independent OS predictor for the MPM patients.
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Affiliation(s)
- Wei Xu
- From the Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 1# Shuai-Fu-Yuan, Wang-Fu-Jing, Beijing, 100730, China
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Extremity soft tissue sarcoma with multiple primary malignancies--Characteristics and outcome. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2016; 42:567-73. [PMID: 26873637 DOI: 10.1016/j.ejso.2016.01.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 12/21/2015] [Accepted: 01/18/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Understanding the incidence and characteristics of multiple primary malignancies (MPM) has implications for guiding appropriate treatment and surveillance of extremity soft tissue sarcoma (STS). OBJECTIVES We sought to examine the incidence of MPM in STS (MPM-STS), and compare their clinicopathologic characteristics and survival to those with STS only. METHODS 585 patients who underwent surgery for extremity STS were reviewed. Logistic regression analyses to identify factors contributing to the development of MPMs and a 1:2 matched case-control analysis to compare survival outcome were performed. RESULTS Of the 585 patients analyzed, 34 (6%) with MPM were identified. On univariate logistic regression analysis, older age (>49 years) at STS diagnosis (p = 0.008) and histologic types of undifferentiated pleomorphic sarcoma or myxofibrosarcoma (p = 0.033) were significant. In multivariate analysis, only older age at STS diagnosis remained significant (OR = 2.5, p = 0.029). Cancer-specific survival of the MPM-STS group was significantly lower than that of the STS-only group (p = 0.031). However, there was no significant difference in STS-specific survival between the two groups (p = 0.208). CONCLUSION Our study suggests that MPM is not uncommon in extremity STS and older age at STS diagnosis is associated with risk of MPM. Prognosis of STS in the MPM-STS group seems similar to that of the STS-only group.
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