ABSTRACT
Independent primary uterine and cervical adenocarcinoma are rare and difficult to identify their origins, which makes treatment decision difficult. A 46-year-old female with endometrioid carcinoma and adenocarcinoma, human papilloma virus (HPV)-associated of the uterine cervix was reported. The patient presented with increased menstrual flow, contact bleeding and watery leucorrhea for more than one year, and the imaging findings showed abnormal uterine morphology, irregular margins, and multiple abnormal signals in uterine cavity and myometrium, which suggested multiple leiomyomas of the uterus. The signal intensity in the right muscle layer was markedly enhanced, suggesting a smooth muscle tumor of uncertain malignant potential. A large number of cystic hypointensity was seen in the cervix, and multiple cysts were considered. The initial preoperative diagnosis was multiple leiomyoma of the uterus, and a hysterectomy operation was planned. During the operation, the uterus was sent for frozen sections. There was a mass in the endometrium of the fundus, with a soft grayish-red cut surface and a clear border with the myometrium, and there was a grayish-white nodule in the cervix with a hard grayish-white cut surface. The two masses were well demarcated from each other, and the distance between them was 30 mm. The result of the frozen sections indicated the malignant tumor of the endometrium, and the extended hysterectomy+pelvic lymphadenectomy+partial resection of the greater omentum was performed. After the operation, the paraffin sections were sent to the Department of Pathology of the Peking University Third Hospital for histochemistry, POLE gene sequencing and HPV RNAscope tests, and the final diagnosis was a synchronous endometrioid carcinoma (POLE-mutant according to the WHO classification) and an adenocarcinoma, HPV-associated of the uterine cervix. Now the patient had been treated with 2 cycles of chemotherapy and her condition was fine. Through the analysis of the histological, immunohistochemical and molecular detection results of this case, the importance of applying HPV RNAscope and TCGA molecular typing in the diagnosis of cervical adenocarcinomas and endometrial carcinomas was emphasized. At the same time, gynecologists should not blindly rely on intraoperative frozen sections, and should pay attention to preoperative pathological examination, and make appropriate operation methods according to the results in order to prevent passivity in the surgery.
Subject(s)
Humans , Female , Middle Aged , Carcinoma, Endometrioid/pathology , Uterine Cervical Neoplasms/pathology , Papillomaviridae , Papillomavirus Infections/pathology , Uterus/pathology , Adenocarcinoma/diagnosisABSTRACT
Abstract Introduction All patients with a new head and neck squamous cell carcinoma (HNSCC) undergo diagnostic panendoscopy as part of the screening for synchronous second primary tumors. It includes a pharyngolaryngoscopy (PLS), a tracheobronchoscopy and esophagoscopy, and a stomatoscopy. Rigid techniques are risky, with long learning curves. Objective We propose a precise description of the panendoscopy protocol. We include an optimization of the PLS technique that completes the flexible esophagoscopy when rigid esophagoscopy isn't performed. Methods The present retrospective observational study includes 122 consecutive patients with a new primary HNSCC who underwent traditional panendoscopy and the new PLS technique between January 2014 and December 2016. A two-step procedure using a Macintosh laryngoscope and a 30° telescope first exposes panoramically the larynx, the upper trachea, and the oropharynx; then, in a second step, the hypopharynx is exposed down to the upper esophageal sphincter. Broncho-esophagoscopy is performed with a rigid and flexible scope. Results In total, 6 (5%) patients presented synchronous tumors (3 in the esophagus, 2 in the oral cavity, and 1 in the larynx 1). Rigid endoscopy was complicated by 2 (1,6%) dental lesions, and had to be completed with a flexible scope in 38 (33%) cases for exposition reasons. The two-step PLS offered a wide-angle view of the larynx, upper trachea, and oroand hypopharynx down to the sphincter of the upper esophagus. The procedure was easy, reliable, safe, repeatable, and effectively completed the flexible endoscopies. Conclusion Rigid esophagoscopy remains a difficult procedure. Two-step PLS combined with flexible broncho-esophagoscopy offers good optical control.
ABSTRACT
ABSTRACT A patient had both ovaries affected by clearly demarcated colliding tumour masses of different gross appearance, histological features and immunohistochemical profiles, corresponding to bilateral collision papillary serous high-grade adenocarcinoma and fibrothecoma. Despite the applied chemotherapy, it led to a lethal outcome for the patient nearly a year after the surgery. Bilateral ovarian tumours raise the question of whether they are primary tumours or metastases. Simultaneous bilateral occurrence of surface epithelial tumours with other types of ovarian tumours is rare. Therefore, it poses a great challenge in proper differential diagnostics.
RESUMEN Una paciente tenía ambos ovarios afectados por masas tumorales en colisión, claramente demarcadas. Las mismas mostraban diferente aspecto macroscópico, y diferentes rasgos histológicos y perfiles inmunohistoquímicos, correspondientes a fibrotecomas y adenocarcinomas serosos papilares bilaterales de alto grado en colisión. A pesar de la quimioterapia aplicada, la condición condujo a un resultado fatal para la paciente, casi un año después de realizada la cirugía. Los tumores ováricos bilaterales plantean la cuestión de si se trata de tumores primarios o metástasis. La ocurrencia bilateral simultánea de tumores epiteliales superficiales con otros tipos de tumores ováricos es rara, y por tanto, plantea un gran desafío a la hora de realizar un diagnóstico diferencial adecuado.
Subject(s)
Humans , Female , Middle Aged , Ovarian Neoplasms/diagnosis , Thecoma/diagnosis , Adenocarcinoma/diagnosis , Immunohistochemistry , Fatal OutcomeABSTRACT
RESUMEN La asociación de dos tumores de diferente origen en un mismo paciente es cada vez más frecuente en la práctica clínica actual. Se presenta un caso con una rara asociación de mixoma cardíaco e hipernefroma, previamente tratado. Ante la presencia de manifestaciones neurológicas, inicialmente se planteó el diagnóstico de metástasis cerebral del tumor renal; luego, con el hallazgo ecocardiográfico de una masa intracardíaca, se pensó en la posibilidad de trombo, por lo que se decidió practicar cirugía cardíaca con carácter urgente para resecarla. El estudio anatomopatológico confirmó la existencia de un mixoma cardíaco, por lo que se trata de un enfermo con dos enfermedades tumorales cuya coincidencia ha sido pocas veces descrita.
ABSTRACT The association of two tumors of different origin in the same patient is becoming more frequent in the current clinical practice. Here is presented a case with a rare association of cardiac myxoma and hypernephroma, previously treated. Due to the presence of neurological symptoms, there was initially set a diagnosis of brain metastasis from the renal tumor; then, with the echocardiographic finding of an intracardiac mass, the possibility of thrombus was considered, therefore a cardiac surgery was decided to be performed urgently in order to resect it. The pathologic examination confirmed the existence of a cardiac myxoma, then, we have a patient with two tumor diseases whose coincidence has been rarely described.
Subject(s)
Myxoma , Carcinoma, Renal Cell , Embolism , Neoplasms, Multiple PrimaryABSTRACT
PURPOSE: Pancreatic cancer associated double primary tumors are rare and their clinicopathologic characteristics are not well elucidated. MATERIALS AND METHODS: Clinicopathologic factors of 1,352 primary pancreatic cancers with or without associated double primary tumors were evaluated. RESULTS: Of resected primary pancreatic cancers, 113 (8.4%) had associated double primary tumors, including 26 stomach, 25 colorectal, 18 lung, and 13 thyroid cancers. The median interval between the diagnoses of pancreatic cancer and associated double primary tumors was 0.5 months. Overall survival (OS) of pancreatic cancer patients with associated double primary tumors was longer than those with pancreatic cancer only (median, 23.1 months vs. 17.0 months; p=0.002). Patients whose pancreatic cancers were resected before the diagnosis of metachronous tumors had a better OS than patients whose pancreatic cancer resected after the diagnosis of metachronous tumors (48.9 months and 13.5 months, p=0.001) or those whose pancreatic cancers were resected synchronously with non-pancreas tumors (19.1 months, p=0.043). The OS of pancreatic cancer patients with stomach (33.9 months, p=0.032) and thyroid (117.8 months, p=0.049) cancers was significantly better than those with pancreas cancer only (17.0 months). CONCLUSION: About 8% of resected pancreatic cancers had associated double primary tumors, and those from the colorectum, stomach, lung, and thyroid were common. Patients whose pancreatic cancer was resected before the diagnosis of metachronous tumors had better OS than those resected after the diagnosis of metachronous tumors or those resected synchronously.
Subject(s)
Humans , Diagnosis , Lung , Neoplasms, Multiple Primary , Neoplasms, Second Primary , Pancreas , Pancreatic Neoplasms , Prognosis , Stomach , Thyroid Gland , Thyroid NeoplasmsABSTRACT
PURPOSE: Double primary colorectal cancer (CRC) and gastric cancer (GC) represent the most common multiple primary malignant tumors (MPMT) in Korea. The recognition and screening of hidden malignancies other than the primary cancer are critical. This study aimed to investigate the clinicopathologic characteristics and survival rates in patients with synchronous or metachronous double primary CRC and GC.METHODS: Between January 1994 and May 2018, 11,050 patients were diagnosed with CRC (n=5,454) or GC (n=5,596) at Gil Medical Center. MPMT and metastatic malignant tumors were excluded from this study. A total of 103 patients with double primary CRC and GC were divided into two groups: the synchronous group (n=40) and the metachronous group (n=63). The incidence, clinicopathologic characteristics, and survival rate of the two groups were analyzed.RESULTS: The incidence of synchronous and metachronous double primary CRC and GC was 0.93%. Double primary CRC and GC commonly occurred in male patients aged over 60 years with low comorbidities and minimal previous cancer history. There were significant differences between the synchronous and metachronous groups in terms of age, morbidity, and overall survival. Metachronous group patients were 6 years younger on average (P=0.009), had low comorbidities (P=0.008), and showed a higher 5-year overall survival rate (94.8% and 61.3%, P < 0.001) in contrast to synchronous group.CONCLUSION: When primary cancer (CRC or GC) is detected, it is important to be aware of the possibility of the second primary cancer (GC or CRC) development at that time or during follow-up to achieve early detection and better prognosis.
Subject(s)
Humans , Male , Colorectal Neoplasms , Comorbidity , Follow-Up Studies , Incidence , Korea , Mass Screening , Neoplasms, Multiple Primary , Neoplasms, Second Primary , Prognosis , Stomach Neoplasms , Survival RateABSTRACT
Multiple primary malignant neoplasms indicate an occurrence of two or more malignancies in a patient, and double primary cancers are the most common type. When the second primary cancer occurs simultaneously or within 6 months after the first primary cancer is diagnosed, it is called synchronous carcinoma. If the second primary cancer occurs after 6 months, it is defined as metachronous carcinoma. Recently, we experienced a patient who was diagnosed as double primary cancer in the nasopharynx and nasal cavity. The tumors occurred simultaneously and histopathological examinations revealed nasopharyngeal nonkeratinizing carcinoma in the right nasopharynx and extranodal NK/T-cell lymphoma in the left nasal cavity (inferior turbinate). In situ hybridization showed positivity for Epstein-Barr virus, which encoded early RNA in the neoplastic cells of both specimens. We present this rare disease entity with a review of the relevant literature and a survey of the clinical characteristics.
Subject(s)
Humans , Herpesvirus 4, Human , In Situ Hybridization , Lymphoma , Nasal Cavity , Nasopharynx , Neoplasms, Multiple Primary , Neoplasms, Second Primary , Rare Diseases , RNAABSTRACT
PURPOSE: Breast cancer is one of the most common malignancies worldwide and the second most common cancer among Korean women. The prognosis of breast cancer is poor in patients with other primary cancers. However, there have been few clinical studies regarding this issue. Therefore, we analyzed the characteristics and prognosis of patients with breast cancer with multiple primary cancers (MPCs). METHODS: Data from the Korean Breast Cancer Society Registry were analyzed. Data from enrolled patients who underwent surgery for breast cancer were analyzed for differences in prognosis dependent on the presence of MPCs, and which MPC characteristics affected their prognosis. RESULTS: Among the 41,841 patients analyzed, 913 patients were found to have MPCs, accounting for 950 total MPCs. There was a significant difference in survival rates between the breast cancer only group and the MPC group. The 5-year survival rates were 93.6% and 86.7% and the 10-year survival rates were 87.5% and 70.4%, respectively. Among the 913 patients with MPCs, patients with two or more MPCs had significantly worse prognoses than patients with a single MPC. With respect to the time interval between breast cancer and MPC occurrence, patients with a 5-year or greater interval had significantly better prognoses than patients with less than 1 year between occurrences. Among MPCs, thyroid cancer was the most common primary cancer. However, this type was not related to the prognosis of breast cancer. Gynecologic cancer, colorectal cancer, upper gastrointestinal cancer, and lung cancer were related to breast cancer prognosis. CONCLUSION: MPCs were a poor prognostic factor for patients with breast cancer. Two or more MPCs and a shorter time interval between occurrences were worse prognostic factors. Although MPCs were a poor prognostic factor, thyroid cancer did not affect the prognosis of patients with breast cancer.
Subject(s)
Female , Humans , Breast Neoplasms , Breast , Colorectal Neoplasms , Gastrointestinal Neoplasms , Lung Neoplasms , Neoplasms, Multiple Primary , Prognosis , Survival Rate , Thyroid NeoplasmsABSTRACT
Lobular capillary hemangioma (LCH) is a benign lesion of unknown etiology. LCH is a rapidly growing lesion usually affecting skin and oral mucosa. It is known to be relatively rare in the nasal cavity or sinuses. LCH bleeds easily even with a little irritation because of its excessive vascularity. Hormonal imbalance and microtrauma are known as the major etiologic factors in the development of LCH. The authors experienced a case of multiple LCH in the nasal cavity, which was completely removed with endoscopic approach. According to the literature review, there has been no case report on multiple lobular capillary hemangioma occurring in the nasal cavity. Therefore, the authors report a case with a review of literatures.
Subject(s)
Granuloma, Pyogenic , Hemangioma, Capillary , Mouth Mucosa , Nasal Cavity , Nasal Septum , Neoplasms, Multiple Primary , SkinABSTRACT
PURPOSE: Breast ultrasonography (US) has been widely used in the preoperative examination of patients with breast cancer. Breast Imaging Reporting and Data System (BI-RADS) category 3 (C3) lesions (probably benign) are regarded as having a low probability of malignancy (< or =2%). The purposes of this study were to verify the malignancy rates for synchronous BI-RADS C3 lesions in patients with breast cancer and consider appropriate management strategies for these lesions. METHODS: Between January 2010 and January 2013, a total of 161 patients underwent surgery in our institute for breast cancer and synchronous BI-RADS C3 lesions. In the US reports, we found records of 219 synchronous BI-RADS C3 nodules in 161 patients. They were excised during surgery for breast cancer management. Stepwise logistic regression analysis was used to identify predictors of malignancy for synchronous BI-RADS C3 lesions. RESULTS: The rate of malignancy among the 219 BI-RADS C3 lesions was 9.6%. In simple logistic regression analysis, the size of the primary tumor (p<0.001), pathologic T (pT) stage (p=0.002), and progesterone receptor (PR) status of the primary tumor (p=0.029) were significant predictive factors. In multiple logistic regression analysis, the pT stage and PR status of the primary tumor remained significant predictors (p=0.004 and p=0.003, respectively), and human epidermal growth factor receptor 2 (HER2) was identified as another significant factor (p=0.006). CONCLUSION: In patients with breast cancer who are scheduled for surgery, needle biopsy or excision should be considered for synchronous BI-RADS C3 lesions identified on preoperative US when the primary tumor has the following risk factors: large size, high PR expression, and HER2 positivity.
Subject(s)
Humans , Biopsy, Needle , Breast , Breast Diseases , Breast Neoplasms , Follow-Up Studies , Information Systems , Logistic Models , Neoplasms, Multiple Primary , Predictive Value of Tests , ErbB Receptors , Receptors, Progesterone , Risk Factors , Ultrasonography , Ultrasonography, MammaryABSTRACT
Breast cancer coexisting with lymphoma is a rare condition with various diagnostic and therapeutic implications. In this report, we describe the case of a 55-year-old Caucasian woman who presented with simultaneous ductal carcinoma in situ of the right breast, and follicular lymphoma involving an inguinal lymph node and the left breast. The patient underwent local excision and radiotherapy for the ductal carcinoma in situ, while a watch and wait strategy was adopted for the lymphoma. Two years later, the patient presented with multifocal ductal carcinoma of the left breast and reappearance of the lymphoma in the left axillary lymph nodes. She underwent bilateral mastectomy, left sentinel node biopsy, and chemotherapy. Synchronous follicular lymphoma and bilateral metachronous breast carcinoma has not been described previously. Diagnosis is based on tissue histology after excision or a needle biopsy. Treatment for these two diseases is distinct, and a multidisciplinary approach should be adopted.
Subject(s)
Female , Humans , Middle Aged , Biopsy , Biopsy, Needle , Breast Neoplasms , Breast , Carcinoma, Ductal , Carcinoma, Intraductal, Noninfiltrating , Diagnosis , Drug Therapy , Lymph Nodes , Lymphoma , Lymphoma, Follicular , Mastectomy , Neoplasms, Multiple Primary , RadiotherapyABSTRACT
PURPOSE: Newly developed extra-mammary multiple primary cancers (MPCs) are an issue of concern when considering the management of breast cancer survivors. This study aimed to investigate the prevalence of MPCs and to evaluate the implications of MPCs on the survival of breast cancer patients. MATERIALS AND METHODS: A total of 8204 patients who underwent surgery at Severance Hospital between 1990 and 2012 were retrospectively selected. Clinicopathologic features and survival over follow-up periods of 5 years were investigated using univariate and multivariate analyses. RESULTS: During a mean follow-up of 67.3 months, 962 MPCs in 858 patients (10.5%) were detected. Synchronous and metachronous MPCs were identified in 23.8% and 79.0% of patients, respectively. Thyroid cancer was the most prevalent, and the second most common was gynecologic cancer. At 5 years. The causes of death in many of the patients with MPCs were not related to breast cancer. Stage-matched analysis revealed that the implications of MPCs on survival were more evident in the early stages of breast disease. CONCLUSION: Breast cancer patients with MPCs showed worse survival, especially when early-stage disease was identified. Therefore, it is necessary to follow screening programs in breast cancer survivors and to establish guidelines for improving prognosis and quality of life.
Subject(s)
Adult , Aged , Female , Humans , Middle Aged , Breast/pathology , Breast Neoplasms/diagnosis , Multivariate Analysis , Neoplasm Metastasis , Neoplasm Staging , Neoplasms, Multiple Primary/diagnosis , Neoplasms, Second Primary/diagnosis , Prognosis , Quality of Life , Republic of Korea/epidemiology , Retrospective Studies , Survival AnalysisABSTRACT
We report here a case of a random synchronous male breast malignancy in a patient with a known base of tongue malignancy that was incidentally detected on a whole body 18-fluorine deoxyglucose positron emission tomography and computed tomography (18F-FDG PET/CT). Patient was referred to us for PET/CT staging and radiotherapy planning for a poorly differentiated squamous cell carcinoma of base of tongue. Histopathologically, the incidentally detected breast lesion was proven to be an invasive ductal carcinoma. 18F-FDG PET/CT being a whole body imaging modality is known to detect a considerable number of synchronous primaries. Synchronous malignancies in the head and neck area and the upper aerodigestive tract are well established. However, synchronous malignancy in male breast is reportedly uncommon. Our case is unique for the fact that a random synchronous dual malignancy of base of tongue and breast in a male patient was detected during a whole body 18F-FDG PET/CT imaging.
Subject(s)
Humans , Male , Breast Neoplasms , Breast , Carcinoma, Ductal , Carcinoma, Squamous Cell , Deoxyglucose , Fluorodeoxyglucose F18 , Head , Neck , Neoplasms, Multiple Primary , Positron-Emission Tomography , Positron Emission Tomography Computed Tomography , Radiotherapy , Tongue , Tongue Neoplasms , Whole Body ImagingABSTRACT
BACKGROUND/AIMS: The purpose of this study was to investigate the clinicopathologic features of double primary cancers of the stomach and colorectum, compared to colorectal cancer alone. METHODS: A retrospective analysis was made of 5,288 patients who underwent colorectal cancer surgery between January 2000 and December 2009 at Severance Hospital of Yonsei University. The clinicopathologic features were analyzed between 63 patients of double primary cancers and case-matched 126 patients of colorectal cancer alone. We classified double primary cancers into subgroups as premetachronous, synchronous and postmetachronous gastric cancer to identify differences between the three subgroups also. RESULTS: Double primary cancers group showed 4.3 year-older age, lower BMI, and higher percentage of peritoneal metastasis, compared to colorectal cancer alone group. Overall and colorectal cancer specific survival did not have any significant difference between two groups. In histologic type of gastric cancer, a high percentage of undifferentiated adenocarcinoma (55.6%) and signet ring cell carcinoma (30.2%) were noted. CONCLUSIONS: Double primary cancers of the stomach and colorectum had older-age onset, lower BMI and higher metastasis to peritoneum than colorectal cancer alone. Combined gastric cancer consisted of high percentage of undifferentiated and signet ring cell carcinomas.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Adenocarcinoma/pathology , Age Factors , Body Mass Index , Carcinoma, Signet Ring Cell/pathology , Colorectal Neoplasms/complications , Odds Ratio , Peritoneal Neoplasms/secondary , Polyps/pathology , Retrospective Studies , Stomach Neoplasms/complicationsABSTRACT
The reported incidence of synchronous multiple primary cancer (SMPC) is rare, and it is even less common to observe synchronous solid tumor with a hematological malignancy. We report five cases of solid tumor presented synchronously with hematological malignancy, all observed within a 2 year period at the oncology department of a university hospital in Shanghai, China. These individual cases included lung adenocarcinoma with chronic myelogenous leukemia, colon cancer with solitary plasmocytoma, gastric adenocarcinoma with diffuse large B cell non-Hodgkin's lymphoma, lung adenocarcinoma with multiple myeloma, and colon cancer with diffuse large B cell non-Hodgkin's lymphoma. It is challenging to therapeutically control the biological behavior of concurrent multiple primary tumors, and there is no standard treatment for such rare conditions. In this paper we discuss these five cases of SMPC and their treatments.
Subject(s)
Adenocarcinoma , China , Colonic Neoplasms , Hematologic Neoplasms , Incidence , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Lung , Lung Neoplasms , Lymphoma, Non-Hodgkin , Multiple Myeloma , Neoplasms, Multiple Primary , PlasmacytomaABSTRACT
Multiple primary neoplasms, defined as the occurrence of multiple malignant neoplasms in the same individual, were first reported by Billroth in 1889. With gradual improvements in diagnostics, and the early detection and effective treatment of malignant neoplasms, the prevalence of multiple primary neoplasms seems to be increasing. Although there have been several reports of triple primary neoplasms in Korea, cases of quadruple neoplasms are rare. Recently, we diagnosed a 69-year-old male with primary neoplasms in the lung, esophagus, vocal cords, and hypopharynx. The authors report this rare case of four metachronous primary neoplasms and provide a review of the literature.
Subject(s)
Aged , Humans , Male , Esophagus , Hypopharynx , Korea , Lung , Neoplasms, Multiple Primary , Prevalence , Vocal CordsABSTRACT
Although cases of simultaneous esophagus and stomach cancer have been reported sporadically, there are rare reports of successful treatment using chemotherapy. We report a case of synchronous esophageal and gastric cancer successfully treated using docetaxel and cis-diammineedichloro-platinum (CDDP) combination chemotherapy instead of surgery. A 82-years-old man with anorexia and progressive weight loss was diagnosed with synchronous esophageal and gastric cancer by endoscopy. Both cancers were diagnosed as resectable by the preoperative clinical staging. However, surgery was contraindicated because of severe lung dysfunction. Moreover, he actively refused radiotherapy and endoscopic management. Therefore, the patient was given combined chemotherapy with docetaxel (65 mg/m2) and CDDP (60 mg/m2). The esophageal and gastric lesion completely disappeared on endoscopy, and there were no residual tumor cells on endoscopic biopsy after three cycles of chemotherapy. Metastatic lymph nodes also completely disappeared on the CT scan. The patient received a total of ten cycles of chemotherapy, without severe adverse effects. The patient remained asymptomatic for 18 months after discontinuation of the chemotherapy, without evidence of local recurrence or distant metastasis. Surgery or endoscopic treatment of both esophageal and gastric cancers is desirable, but, if medically inoperable, chemotherapy can be alternative treatment option.
Subject(s)
Aged, 80 and over , Humans , Male , Antineoplastic Agents/therapeutic use , Cisplatin/therapeutic use , Drug Therapy, Combination , Endoscopy, Digestive System , Esophageal Neoplasms/complications , Positron-Emission Tomography , Stomach Neoplasms/complications , Taxoids/therapeutic use , Tomography, X-Ray ComputedABSTRACT
Multiple primary neoplasms, defined as the occurrence of multiple malignant neoplasms in the same individual, were first reported by Billroth in 1889. With gradual improvements in diagnostics, and the early detection and effective treatment of malignant neoplasms, the prevalence of multiple primary neoplasms seems to be increasing. Although there have been several reports of triple primary neoplasms in Korea, cases of quadruple neoplasms are rare. Recently, we diagnosed a 69-year-old male with primary neoplasms in the lung, esophagus, vocal cords, and hypopharynx. The authors report this rare case of four metachronous primary neoplasms and provide a review of the literature.
Subject(s)
Aged , Humans , Male , Esophagus , Hypopharynx , Korea , Lung , Neoplasms, Multiple Primary , Prevalence , Vocal CordsABSTRACT
Hereditary nonpolyposis colorectal cancer (HNPCC) is an autosomal dominant inherited disease characterized by onset at a relatively early age, an excess of synchronous and metachronous tumors, and a variety of extracolorectal malignancies. Small bowel carcinoma reported, is included in the tumor spectrum of HNPCC, but the frequency of occurrence of this tumor in HNPCC patients is comparatively rare. In Korea, several cases of multiple primary cancers in patients with HNPCC have been reported, however, primary jejunal adenocarcinoma in conjunction with multiple primary cancers in the digestive tract has rarely been reported. Recently, we evaluated a 61-year-old male diagnosed with metachronous triple primary cancers of the jejunum, stomach, and colon. We report this rare case of primary jejunal adenocarcinoma as a part of metachronous triple cancers along with a review of the relevant literature.
Subject(s)
Humans , Male , Middle Aged , Adenocarcinoma , Colon , Colorectal Neoplasms, Hereditary Nonpolyposis , Gastrointestinal Tract , Jejunal Neoplasms , Jejunum , Korea , Microsatellite Instability , Neoplasms, Multiple Primary , StomachABSTRACT
A 60-year-old female was admitted with epigastric pain lasting a month. Preoperative diagnosis was choledochal cyst with anomalous pancreaticobiliaryductal union (APBDU), C-P type. A papillary mass measuring 2.5 x 1.9 cm was found adjacent to the pancreaticocholedochal junction. Gallbladder (GB) cancer was also observed. Pyloric-preserving pancreaticoduodenectomy (PPPD) was performed. The patient received adjuvant chemotherapy/radiation therapy on the tumor bed. The gallbladder cancer showed serosal invasion, while the bile duct cancer extended into the pancreas. Although common bile duct (CBD) cancer lesion showed focally positive for p53 and the gallbladder cancer lesion showed negative for p53, the Ki-67 labeling index of the CBD cancer and GB cancer were about 10% and 30%, respectively. Nine months after curative resection, a stricture on the subhepatic colon developed due to adjuvant radiation therapy. Localized peritoneal seedings were incidentally found during a right hemicolectomy. The patient underwent chemotherapy and had no evidence of tumor recurrence for two years after PPPD.