ABSTRACT
Intramural metastasis (IM) is defined as metastatic tumor from the primary tumor to the digestive tracts through the intramural lymphatic system. It can occur in esophageal, gastric and colorectal carcinomas, especially in esophageal squamous cell carcinoma. The combination of histological morphological evaluation and molecular pathology can assist in the identification of IM and multiple primary carcinomas (MPCs). IM is usually associated with a poor prognosis and also affects the treatment. This article reviews the anatomical and histological basis, clinicopathological characteristics, treatment and prognosis of IM in ESCC, the identification of IM and MPCs and how to improve the detection rate of IM, to guide accurate diagnosis and treatment.
ABSTRACT
Multiple primary carcinomas(MPC),also known as multiple cancer,refers to single or multi-ple organ tissues occur more than two primary cancer in the same patient.In this case,it has been found multiple simultaneous cancers within 6 months.It is called metachronous cancer,which multiple cancers come from differ-ent original cancers more than 6 months.It is reported that there is a low incidence rate of multiple primary carci-nomas,which is largely influenced by radiotherapy and chemotherapy.Multiple primary cancers are easy to be confused with metastatic tumors in clinical practice,both of them are quite different in terms of treatment and prognosis.Therefore,it is helpful to improve the survival of patients by timely diagnosis and treatment.This article reported a case of multiple primary carcinomas.
ABSTRACT
Multiple primary carcinomas(MPC),also known as multiple cancer,refers to single or multi-ple organ tissues occur more than two primary cancer in the same patient.In this case,it has been found multiple simultaneous cancers within 6 months.It is called metachronous cancer,which multiple cancers come from differ-ent original cancers more than 6 months.It is reported that there is a low incidence rate of multiple primary carci-nomas,which is largely influenced by radiotherapy and chemotherapy.Multiple primary cancers are easy to be confused with metastatic tumors in clinical practice,both of them are quite different in terms of treatment and prognosis.Therefore,it is helpful to improve the survival of patients by timely diagnosis and treatment.This article reported a case of multiple primary carcinomas.
ABSTRACT
Objective:The implementation of a multidisciplinary team (MDT) approach for palliative treatment of patients with multi-ple primary carcinomas (MPCs) was evaluated in Tianjin Medical University Cancer Institute and Hospital. Methods:A total of 40 pa-tients with MPCs who attended the consultation by MDT in our hospital from January 1, 2014 to April 21, 2016 were analyzed retro-spectively. Clinical data of the 40 cancer patients were reviewed. The essential characteristics and results of MDT treatment decisions were summarized and expected outcomes were evaluated. Results:A total of 40 cases with MPCs were included in MDT assessment, accounting for 6.4%of the 629 patients who were handled by the MDT. A total of 39 MDT decisions were followed up successfully. Among these MDT decisions, 26 (65%) were fully implemented, 7 (17.5%) were partially implemented, and 6 (15.0%) were unimple-mented. Expected outcomes were achieved in 25 (96.2%) patients of the fully implemented concordant group, 4 (57.1%) patients of the partially concordant group, and 1 (16.7%) patient from the unimplemented group. Conclusion:MDT specializing on palliative treat-ment can provide recommendations for standardized individualized comprehensive treatment of patients with MPCs. MDT modality should be further improved and widely used for palliative treatment.
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Objective To investigate the relationship between thyroid and breast multiple primary carci-nomas.Methods A total of 24 cases of multiple primary tumors of thyroid and breast admitted from Jan .2011 to Jun.2013 in First Affiliated Hospital of Zhengzhou University were retrospectively analyzed .Results The 24 samples were confirmed as the tumor of thyroid and breast by ultrasonography .The patients underwent operation and adjuvant therapy after fine-needle aspiration biopsy , mammography and other relevant examinations .All the malignancies of thyroid and breast were confirmed by pathology .Among the 24 cases, 19 patients were invasive ductal carcinomas , 2 patients were diagnosed as intraductal carcinomas , 1 patient was confirmed as intraductal papillary carcinoma , 1 case was invasive lobular carcinoma with invasive ductal carcinoma , and 1 case was inva-sive ductal carcinoma with intraductal carcinoma .All the thyroid malignancies were papillary thyroid carcinomas . The results of immunohistochemistry indicated that , among the 24 patients of thyroid and breast multiple primary carcinomas , 11 cases were ER (+) in both thyroid cancers and breast cancers , moreover , 8 cases were ER (-) in both thyroid cancers and breast cancers .The difference between the expression of ER in the tumors of thyroid and breast had no statistical significance (P>0.05).Conclusions Ultrasonography is a simple and effective im-aging method that can discover the multiple primary tumors of thyroid and breast .For patients of thyroid cancer , breast cancer should be excluded routinely .The thyroid should also be examined simultaneously in breast cancer patients.Once the possibility of one gland tumor is discovered , we should pay more attention to the other gland . Particularly, the other gland should be examined carefully for patients with ER (+).
ABSTRACT
Synchronous multiple primary carcinomas refers to 2 or more than 2 kinds of different primary malignant tumors develop synchronously or in 6 months.The incidence of synchronous multiple primary carcinoma is low.A patient with esophageal basaloid squamous cell carcinoma (BSCC) and gastric adenocarcinoma was admitted to the First People's Hospital of Lianyungang in October 2011.The main symptom of this patient was dysphagia,and multiple lesions were found in esophagus,cardia and stomach fundus by gastroscopy respectively.On computed tomography image,eminence lesion in esophageal midpiece and wall thickening from esophagus-cardia to stomach fundus were displayed and were both enhanced slightly by enhancement scanning.The esophageal and cardia tumors were resected via left thoracic approach,and postoperative pathological examination revealed esophageal BSCC and moderately differentiated adenocarcinoma of cardia respectively.Comedo necrosis and red basal membrane material were seen under light microscope.The expressions of cytokeratin 5/6 and P63 were positive,the expression of cytokeratin L was weak positive and the expressions of synaptophysin,chromogranin A and CD117 were negative.The patient suffered from pleural effusion and multiple liver metastases after 4 months follow-up and died of liver metastases in May 2012.Multiple primary carcinomas including esophageal BSCC and gastric adenocarcinoma are rarely seen in clinical practice.Their diagnosis and differential diagnosis mainly depend on histological morphology and immunohistochemical method.Surgical resection combined with postoperative radiotherapy and chemotherapy is selectable,but the prognosis is poor.
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Objective:To investigate the diagnosis and treatment principles of multiple primary colorectal carcinoma(MPCC).Methods:A retrospective analysis was made on 63 patients with MPCC admitted from January 1993 to January 2007 in our hospital. Results:The incidence of MPCC was 2.1%(63/3 021) with 31 cases being synchronous carcinoma(SC) and 32 cases diagnosed as metachronous carcinoma(MC). Male to female ratio was 2.5:1.Most tumors were located in rectum and sigmoid colon.A total of 34 cases(54.0%) were diagnosed by fiberoptic colonoscopy before operation.The diagnosis rate of SC by fiberoptic colonoscopy before operation and during operative exploration were all 38.7%(12 cases). The diagnosis rate of MC by fiberoptic colonoscopy before operation and during operative exploration were 68.7%(22 cases) and 6.25%(2 cases) respectively.The overall 5-year survival rate of the patients in SC was 45%(9/20),the overall 5-year survival rate of the patients in MC after the first operation was 72.4%(21/29). Conclusion:Clinician should improve the recognition of MPCC.Patients with colorectal carcinoma should undergo routine fibercolonscopy and standard radical excision. Periodic follow-up for the high-risk group should be highlighted.