Synchronous carcinoma of the floor of mouth carcinoma with esophageal carcinoma: a case report / 华西口腔医学杂志

This study presents a case of synchronous multiple primary cancers involving floor of mouth carcinoma with esophageal carcinoma. Literature was reviewed to summarize the incidence, location, diagnosis, treatment characteristics, and prognosis to improve understanding and awareness of the multiple primary cancer. As a result, early discovery, early diagnosis, and effective treatment can help prolong survival and improve the quality of life of patients.

Double primary carcinoma of endometrial carcinoma and colorec-tal carcinoma: retrospective analysis of 34 cases and discussion of its relationship with Lynch syndrome / 中国肿瘤临床

Objective:To approach the clinicopathologic characteristics, treatment modalities, and prognosis of the patients with double primary carcinoma of endometrial carcinoma and colorectal carcinoma and analyze the relationship between this disease and Lynch syndrome. Methods:The clinicopathologic and follow-up data of 34 cases with double primary carcinoma of endometrial carci-noma and colorectal carcinoma treated in Cancer Hospital of Chinese Academy of Medical Sciences were reviewed. Results:The medi-an age of the 34 patients was 51.5 years old (ranging from 39 to 76). Twenty-two of the total cases (22/34, 64.7%) had tumor family his-tory. The pathologic results indicated that 79.4%(27/34) was endometrioid adenocarcinoma. In the 34 cases, 33 were treated by surgical procedure. Of the 33 cases undergoing surgery, 17 patients with endometrial carcinoma and 19 with colorectal carcinoma received fur-ther adjuvant treatment of chemotherapy and/or radiotherapy. The 2-and 5-year survival rates were 84.3%and 63.1%in the 34 cases, respectively. Conclusion:The age of onset is earlier in the patients with double primary carcinoma than in those with sporadic colorec-tal carcinoma. Some cases have cancer family history, and their survival rates are similar to those of the patients with sporadic colorec-tum carcinoma. Diagnosis of some patients with double primary carcinoma may be in line with Lynch syndrome.

A case report of primary hepatocellular carcinoma with gallbladder cancer / 西安交通大学学报(医学版)

ABSTRACT:Objective To a rare case of double primary cancer (hepatocellular carcinoma with gallbladder)to guide clinical application.Methods and Results We reported one case of primary hepatocellular carcinoma and gallbladder.A male patient,54 years old,had main complaints of intermittent right upper quadrant pain for 4 days. The abdominal CT of the local county hospital showed gallstones,gallbladder with liver infiltration.And then he went to the First Affiliated Hospital of Xi’an Jiaotong University for further treatment.Laboratory examination revealed:HBsAg(+),HBcAb(+),alpha-fetoprotein (AFP)> 60 500 ng/mL,carcinoembryonic antigen (CEA) 5.25 ng/mL.Abdominal CT showed hilar slightly stronger light echo groups:liver cancer or gallbladder cancer? Hepatic artery and portal vein CT imaging (CTA+CTV)examination showed the malignant tumor shadow in the inside of the left hepatic lobe huge,uneven thickening of the gallbladder wall,suspected liver disease with gallbladder infringement or gallbladder disease with liver infringement. With the preoperative preliminary consideration of primary liver cancer with infiltration of the gallbladder,we chose the operation as the resection of segment Ⅳ b and Ⅴ of the liver,cholecystectomy and T tube drainage.Pathological examination postoperative showed the bulky liver carcinoma grade Ⅲ and the poorly differentiated adenocarcinoma of gallbladder.A month later,abdominal CT showed the tumor spread intrahepatic,prompting the poor prognosis.Conclusion The two which are not continuous,which is the standard of double primary cancer,are not suitable for all double primary cancers.This case provides useful experience for future similar diagnosis and treatment of disease,and also helps us with timely and accurate identification of “metastatic”or “primary”,which is the key point for clinicians to give patients an effective treatment.

Synchronous Triple Primary Cancers - Liver, Gallbladder and Pancreas

We report here on a case of synchronous triple primary cancers that occurred in the liver, gall bladder and pancreas. A 69-year-old man who presented with symptoms of diarrhea, poor oral intake and dyspepsia was referred to our hospital. The diagnostic images showed a gall bladder mass (about 2cm in size), a pancreas head mass (2.7cm in size) and a liver mass (about 4cm in size) in segment 7. On positron emission tomography, the liver mass did not show a hypermetabolic uptake. We could not confirm a liver mass between the metastatic lesion and the hepatocellular carcinoma, and so we performed liver biopsy, which revealed hepatocellular carcinoma. Pylorus-preserving pancreaticoduodenectomy, extended cholecystectomy and liver wedge resection of segment 7 were performed. The biopsy showed gall bladder adenocarcinoma, pancreas ductal adenocarcinoma and hepatocellular carcinoma. Many multiple primary malignant neoplasms have previously been reported on, however, reports in the medical literature on synchronous multiple primary cancers occurring in the hepatobiliary and pancreas systems are very rare.

Clinical Characteristics of Multiple Primary Colorectal Cancers / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Although multiple primary colorectal cancer has been recognized as a significant clinical entity, its clinical and pathological features and its prognosis are still controversial. The purpose of this study was to clarify clinical and pathological features of multiple primary colorectal cancer. MATERIALS AND METHODS: Among 1669 patients who underwent surgery for primary colorectal cancer from January 1997 to June 2005, 26 patients (1.6%) with multiple primary colorectal cancer were identified. We reviewed clinical characteristics including diagnostic interval, lesions, operating methods, and TNM stage, and we defined the index lesion as the most advanced lesion among the synchronous lesions. For the purposes of the study, the colon and rectum were classified into three segments. The right-side colon included the appendix, cecum, ascending colon, hepatic flexure, and transverse colon, and the left-side colon included the splenic flexure, descending colon, and sigmoid colon. RESULTS: Of the 26 patients with multiple primary colorectal cancers, nineteen patients were male and seven patients were female, with a mean age of 61.5 years. Nineteen patients had synchronous colorectal cancers and seven patients had metachronous colorectal cancers. In the metachronous cases, the mean diagnosticinterval was 36.8 months. The site of the first lesion in metachronous colorectal cancers was the right colon in five cases (71.4%) and the left colon in two cases (28.6%), and the site of the second lesion was the rectum in six cases (55.5%), the right colon in three cases (33.3%), and the left colon in one case. The TNM stage of the second lesions in the metachronous colorectal cancers was stage II in four cases (57.1%), stage III in one case (14.3%), and stage IV in one case (14.3%). For the synchronous colorectal cancers, the operation methods were single-segment resection combined with endoscopic mucosal resection in five cases (26.3%), single-segment resection alone in six cases, two-segment resection in six cases, and total colectomy in two cases. CONCLUSION: In metachronous colorectal cancers, the secondary lesions were later-stage cancer. Therefore, careful postoperative follow-up is necessary for patients who have undergone surgery for colorectal cancers. Further study of therapeutic modalities is important for synchronous colorectal cancers.

Multiple Primary Cancers Including Colorectal Cancer

PURPOSE: With advance in diagnostic techniques and treatment modalities, it has been increasing that the patients with colorectal cancer experience another primary malignancies. Understanding the characteristics of multiple primary malignancies is important to establish an effective surveillance program for the early detection of second cancer. METHODS: The database of 2,709 patients diagnosed with colorectal cancer between 1985 and 2007 in Kangnam St. Mary's Hospital was analyzed retrospectively. RESULTS: Out of 2,709 patients, 102 (3.76%) of them were found to have multiple malignancies. Among them, 37 patients had synchronous cancers and 65 patients had metachronous cancers. The most common site of multiple primary malignancies was the stomach, followed by kidney, thyroid and breast. CONCLUSIONS: In the patients with colorectal cancer, it should be considered to evaluate multiple primary malignancies, especially stomach, during the routine follow up. And the most frequent multiple primary cancer before colorectal cancer was also stomach cancer. Careful attention should be paid to the colorectal cancer in stomach cancer patients.

Multiple Primary Malignant Neoplasms in Genitourinary Tract / 대한비뇨기과학회지

The phenomenon of multiple primary malignant tumors in one patient synchronously or metachronously is no more curiosity. So, careful follow up study and early diagnosis of those lesions, based on an awareness of the possibility of the second cancer, will substantially increase the survival of these patients. We collected nine cases of multiple primary cancers according to Moertel's classification histologically proved and treated from 1985 to l992 at Kosin Medical Center. The results were as follows; 1. The average age of the patients was 60.9 years with dominance in seventh decade 2. The male to female ratio was 7: 2 with significant dominance in male. 3. The synchronous to metachronous ratio was 6: 3, in metachronous cases the average time interval between 1st and 2nd cancers was 122 months. 4. In 6 cases of synchronous cancers, there were penile cancer and hepatoma, renal cell carcinoma and bladder cancer, prostatic cancer and bladder cancer, bladder cancer and colon cancer, and prostatic cancer and lung cancer. In 3 cases of metachronous cancers, there were bladder cancer and uterine cervical cancer, bladder cancer and stomach cancer, and renal cell carcinoma and synovial sarcoma. 5. In 3 cases of metachronous cancers, adjuvant therapy was performed in 2 cases after operation including one case of chemotherapy and another case of radiotherapy.

The expression of MMR、p53、Bax、PCNA and microsatellite instability in multiple primary colorectal cancer / 中国普通外科杂志

Objective To study microsatellite instability(MSI) in multiple primary colorectal carcinoma(MPCC) and solitary colorectal tumor(SCT), and to explore the relationship between the expression of mismatch repair(MMR)、p53、Bax、PCNA and MSI. Methods The expression of MMR、p53、Bax、 PCNAwere detected by immunohistochemical staining, and MSI at five microsatellite loci were examined by PCR-SSLP in 51 tumors from 38 MPCC patients and 35 SCT cases. Results The replication errors positive phenotype was observed in 27 of 51(53%) tumor foci from MPCC cases, and in 6 of 35(17%) SCT cases. There was an inverse correlation between replication errors (RER) positive and expression of p53; the PCNA labeling index of RER positive tumors were significantly lower than of RER negative tumors; RER positive related strongly with poor differentiation, the proclivity for proximal colon. Conclusions MSI may play an important role in the development of MPCC and may be used as a tumor marker of MPCC.