1
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Chen N, Shi L, Ge J, Jia R, Jiang J. Risk and prediction of multiple primary malignancies after early gastric cancer. Front Oncol 2023; 13:1205358. [PMID: 37560468 PMCID: PMC10409482 DOI: 10.3389/fonc.2023.1205358] [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: 04/13/2023] [Accepted: 07/10/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Patients with early gastric cancer have increased risk of developing multiple primary malignancies (MPM) due to improved survival rates. The purpose of this study was to evaluate the clinicopathological features of MPM and to generate a useful tool for predicting the development of MPM after early gastric cancer. METHODS We selected 1025 early gastric cancer patients with complete medical records for a retrospective analysis. The Cox proportional risk regression model was used to analyze the independent risk factors for the development of MPM in early gastric cancer. RStudio software was used to compare the OS of early gastric cancer patients with and without MPM, and a nomogram was established to predict the probability of MPM 1-, 2-, 3-year after early gastric cancer. The predictive effectiveness of the nomogram was evaluated by the C-index and calibration curve. Decision curve analysis (DCA) measured the applicability of the nomogram to clinical practice. RESULTS Of the 1025 patients with early gastric cancer, 66 patients (6.4%) had 69 primary cancers other than early gastric cancer. They had a median follow-up of 41 months, and their cumulative incidence of MPM was 4.9%, 5.4% and 5.9% after 1-, 2-, and 3- year, respectively. Oesophageal cancer was the most frequently detected MPM, followed by lung and colorectal cancers. Male (p=0.038), age ≥65 years (p=0.003), smoking history (p=0.036), and lymph node metastasis (p=0.013) were independent risk factors for MPM in patients with early gastric cancer. Patients with early gastric cancer with MPM had a worse OS prognosis than patients with early gastric cancer without MPM (p<0.001). The internally validated nomogram predicted the probability of developing MPM after early gastric cancer (C index= 0.697). The calibration chart showed that the predicted probability of MPM in early gastric cancer was similar to the observed result, and the DCA showed strong clinical practicability. CONCLUSION After the diagnosis and treatment of early gastric cancer, we should be alert to the possibility of MPM and perform regular and careful monitoring.
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Affiliation(s)
| | | | | | | | - Junmei Jiang
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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2
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Merhaben S, Mohamed AB, Khsiba A, Mahmoudi M, Nechi S, Chelbi E, Kilani H, Yakoubi M, Hamzaoui ML, Medhioub M, Azouz MM. Synchronous primary gastric and renal tumors: a case report. Future Sci OA 2023; 9:FSO865. [PMID: 37228858 PMCID: PMC10203905 DOI: 10.2144/fsoa-2023-0009] [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: 01/24/2023] [Accepted: 05/02/2023] [Indexed: 05/27/2023] Open
Abstract
Synchronous multiple primary cancers of the stomach and kidney are very rare, only 45 cases of synchronous multiple primary cancers of the stomach and kidney had been reported in the literature up until 2020. Thus far, no particular risk factors have been identified. We present a case of synchronous multiple primary cancers of the stomach and kidney in a 67-year-old female presenting with a 3-month history of vomiting and abdominal pain. The diagnosis of gastric adenocarcinoma with signet ring cells was confirmed through upper endoscopy with biopsies, while CT-guided biopsies of the renal tumor confirmed the diagnosis of primary kidney neoplasm.
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Affiliation(s)
- Salma Merhaben
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia
| | - Asma Ben Mohamed
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia
| | - Amal Khsiba
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia
| | - Moufida Mahmoudi
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia
| | - Salwa Nechi
- Histopathology Department, Mohamed Taher Maamouri Hospital,Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia
| | - Emna Chelbi
- Histopathology Department, Mohamed Taher Maamouri Hospital,Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia
| | - Houda Kilani
- Histopathology Department, Mohamed Taher Maamouri Hospital,Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia
| | - Manel Yakoubi
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia
| | - Mohamed Lamine Hamzaoui
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia
| | - Mouna Medhioub
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia
| | - Mohamed Moussadak Azouz
- Gastroenterology Department, Mohamed Taher Maamouri Hospital, Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia
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3
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El-Badrawy A, Shebel H, El Atta HMA. MDCT diagnosis of synchronous primary gastrointestinal tract carcinoma and other solid malignancies: case series study. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2022. [DOI: 10.1186/s43055-022-00707-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Abstract
Background
The presentation of synchronous multiple primary tumors is rare. The aim of this report was to report an uncommon series of cases diagnosed with synchronous gastrointestinal tract carcinoma and other solid malignancies by multidetector computed tomography.
Case presentation
Our report included 34 patients with synchronous gastrointestinal tract carcinoma and other solid malignancies from November 2009 to September 2019. They were 14 men and 20 women (mean age, 65.5 year; range, 52–82 years). The highest number of GIT cases were colonic carcinomas detected in 70% (24/34) of the patients. The most frequent extra-gastrointestinal primary malignancy sites were renal cell and breast carcinomas, 17.6% (6/34) of each.
Conclusions
Careful preoperative evaluation is recommended to detect this pattern of synchronous extra-gastrointestinal tumors. More reports of such cases should help to clarify the pathogenesis of this phenomenon and may lead to a new treatment strategy for synchronous gastrointestinal malignancy and other solid malignancies.
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4
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Bellini MI, Lori E, Forte F, Lauro A, Tripodi D, Amabile MI, Cantisani V, Varanese M, Ferent IC, Baldini E, Ulisse S, D’Andrea V, Pironi D, Sorrenti S. Thyroid and renal cancers: A bidirectional association. Front Oncol 2022; 12:951976. [PMID: 36212468 PMCID: PMC9538481 DOI: 10.3389/fonc.2022.951976] [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: 05/24/2022] [Accepted: 08/22/2022] [Indexed: 12/01/2022] Open
Abstract
There is a deep interrelation between the thyroid gland and the kidney parenchyma, with dysfunction of the first leading to significant changes in renal metabolism and vice versa. Given the recognition of cancer as a systemic disease, the raise of thyroid tumors and the common association of several malignancies, such as breast cancer, prostate cancer, colorectal cancer, and other, with an increased risk of kidney disease, public health alert for these conditions is warranted. A systematic review of the current evidence on the bidirectional relationship between thyroid and renal cancers was conducted including 18 studies, highlighting patient's characteristics, histology, time for secondary malignancy to develop from the first diagnosis, treatment, and follow-up. A total of 776 patients were identified; median age was 64 years (range: 7-76 years). Obesity and family history were identified as the most common risk factors, and genetic susceptibility was suggested with a potential strong association with Cowden syndrome. Controversy on chemo and radiotherapy effects was found, as not all patients were previously exposed to these treatments. Men were more likely to develop kidney cancer after a primary thyroid malignancy, with 423/776 (54%) experiencing renal disease secondarily. Median time after the first malignancy was 5.2 years (range: 0-20 years). With the advancement of current oncological therapy, the prognosis for thyroid cancer patients has improved, although there has been a corresponding rise in the incidence of multiple secondary malignancy within the same population, particularly concerning the kidney. Surgery can achieve disease-free survival, if surveillance follow-up allows for an early localized form, where radical treatment is recommended.
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Affiliation(s)
| | - Eleonora Lori
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Flavio Forte
- Department of Urology, M. G. Vannini Hospital, Rome, Italy
| | - Augusto Lauro
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Domenico Tripodi
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Maria Ida Amabile
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Vito Cantisani
- Department of Radiological, Anatomopathological and Oncological Sciences, Sapienza University of Rome, Rome, Italy
| | - Marzia Varanese
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | | | - Enke Baldini
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Salvatore Ulisse
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Vito D’Andrea
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Daniele Pironi
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Salvatore Sorrenti
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
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5
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El-Badrawy A. MDCT evaluation of synchronous breast carcinoma and other solid malignancies. Breast Dis 2021; 40:275-281. [PMID: 34120894 DOI: 10.3233/bd-201065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Multiple primary malignancies are two or more malignancies in an individual without any relationship between the tumors. The development of improved diagnostic techniques, increased survival of cancer patients and the growing life expectancy have all contributed to the increased frequency of this phenomenon. OBJECTIVE The aim of this study is to review the multidetector computed tomography (MDCT) findings of synchronous breast carcinoma and other solid malignancies. METHODS This retrospective study included 65 patients confirmed with diagnosis of synchronous breast carcinoma and other solid malignancies. CT scanning was performed using 128 MDCT in all patients. All one hundred-thirty malignancies underwent pathological evaluation. RESULTS Out of 4120 patients with breast carcinoma; 65 patients were diagnosed with other synchronous primary solid malignancy. All one hundred-thirty malignancies were confirmed pathologically. Breast carcinoma detected in all 65 patients; of them metastatic breast carcinoma detected in 8 patients. Hepatocellular carcinoma was detected in 18 patients, Non-Hodgkin lymphoma (NHL) in 12 patients, endometrial carcinoma in 8 patients, uterine sarcoma in 3 patients, malignant mixed Müllerian tumor in one patient, ovarian carcinoma in 5 patients, renal cell carcinoma in 4 patients, thyroid carcinoma in 4 patients, gastric carcinoma in 2 patients, colonic carcinoma in 2 patients, ano-rectal carcinoma in one patient, hilar cholangiocarcinoma in 2 patients, malignant melanoma in 2 patients and bronchogenic carcinoma in one patient. CONCLUSIONS Patients with breast carcinoma have a risk of other synchronous primary malignancy. So, careful preoperative examination is recommended to improve the patients' prognosis. MDCT scanning is accurately imaging modality for evaluation of synchronous breast carcinoma and other solid malignancies. The aim of treatment in cancer patients should always be curative even in the presence of multiple malignancies.
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Affiliation(s)
- Adel El-Badrawy
- Radiology Department, Mansoura University Faculty of Medicine, Mansoura, Dakahlya, Egypt
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6
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Martín-Pérez JA, Torres-Silva C, Tenorio-Arguelles R, García-Corona DA, Silva-González S, Dominguez-Rodriguez JA, De Alba-Cruz I, Nagore-Ancona JF, González-Luna JA, López-Bochm KA. Gastric carcinoma and renal cell carcinoma as an atypical presentation of multiple primary malignancies: a case report and review of the literature. J Med Case Rep 2020; 14:234. [PMID: 33261664 PMCID: PMC7709286 DOI: 10.1186/s13256-020-02576-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/03/2020] [Indexed: 12/19/2022] Open
Abstract
Background Gastric carcinoma (GC) with second primary malignancy (SPM) is the most frequent combination within the multiple primary malignancies (MPM) group. The presentation of a GC associated with a synchronized SPM in the kidney is extremely rare and unusual. This study presents a rare case of synchronous tumors, describes the main associated risk factors, and emphasizes the need to rule out SPM. Main body We present the case of a 63-year-old Hispanic woman with a history of smoking, weight loss, and gastrointestinal (GI) bleeding. GC was diagnosed by endoscopy, and during her workup for metastatic disease, a synchronous SPM was noted in the left kidney. The patient underwent resection of both tumors with a satisfactory postoperative course. A systematic review of the literature was performed using the Medline/PubMed, Science Direct, Scopus, and Google Scholar databases. A search of the literature yielded 13 relevant articles, in which the following main risk factors were reported: the treatment utilized, the grade and clinical stage, histopathological report, and in some cases survival. It is concluded that advanced age (> 60 years) and smoking are the main associated risk factors. Conclusion Gastric carcinoma is the second most frequent neoplasm of the GI tract and the main neoplasm that presents a SPM. MPM screening is recommended in patients with gastric cancer. The clinical discovery of MPM of renal origin is rare and hence the importance of the current report.
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Affiliation(s)
- J A Martín-Pérez
- Surgical Department, "General Ignacio Zaragoza" Regional Hospital, Ejército Constitucionalista, Chinam Pac de Juárez, Calz. Ignacio Zaragoza 1711, 09220, Mexico City, MX, Mexico. .,Social Services and Security Institute for the State Employees (I.S.S.S.T.E.), Mexico City, MX, Mexico.
| | - C Torres-Silva
- Oncology Surgical Department, "General Ignacio Zaragoza" Regional Hospital, Mexico City, MX, Mexico.,Social Services and Security Institute for the State Employees (I.S.S.S.T.E.), Mexico City, MX, Mexico
| | - R Tenorio-Arguelles
- Oncology Surgical Department, "General Ignacio Zaragoza" Regional Hospital, Mexico City, MX, Mexico.,Social Services and Security Institute for the State Employees (I.S.S.S.T.E.), Mexico City, MX, Mexico
| | - D A García-Corona
- Oncology Surgical Department, "General Ignacio Zaragoza" Regional Hospital, Mexico City, MX, Mexico.,Social Services and Security Institute for the State Employees (I.S.S.S.T.E.), Mexico City, MX, Mexico
| | - S Silva-González
- Oncology Surgical Department, "General Ignacio Zaragoza" Regional Hospital, Mexico City, MX, Mexico.,Social Services and Security Institute for the State Employees (I.S.S.S.T.E.), Mexico City, MX, Mexico
| | - J A Dominguez-Rodriguez
- Surgical Department, "General Ignacio Zaragoza" Regional Hospital, Ejército Constitucionalista, Chinam Pac de Juárez, Calz. Ignacio Zaragoza 1711, 09220, Mexico City, MX, Mexico.,Social Services and Security Institute for the State Employees (I.S.S.S.T.E.), Mexico City, MX, Mexico
| | - I De Alba-Cruz
- Surgical Department, "General Ignacio Zaragoza" Regional Hospital, Ejército Constitucionalista, Chinam Pac de Juárez, Calz. Ignacio Zaragoza 1711, 09220, Mexico City, MX, Mexico.,Social Services and Security Institute for the State Employees (I.S.S.S.T.E.), Mexico City, MX, Mexico
| | - J F Nagore-Ancona
- Surgical Department, "General Ignacio Zaragoza" Regional Hospital, Ejército Constitucionalista, Chinam Pac de Juárez, Calz. Ignacio Zaragoza 1711, 09220, Mexico City, MX, Mexico.,Social Services and Security Institute for the State Employees (I.S.S.S.T.E.), Mexico City, MX, Mexico
| | - J A González-Luna
- Surgical Department, "General Ignacio Zaragoza" Regional Hospital, Ejército Constitucionalista, Chinam Pac de Juárez, Calz. Ignacio Zaragoza 1711, 09220, Mexico City, MX, Mexico.,Social Services and Security Institute for the State Employees (I.S.S.S.T.E.), Mexico City, MX, Mexico
| | - K A López-Bochm
- Pathology Department, "General Ignacio Zaragoza" Regional Hospital, Mexico City, MX, Mexico.,Social Services and Security Institute for the State Employees (I.S.S.S.T.E.), Mexico City, MX, Mexico
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7
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Triple Metachronous Malignancies with Thyroid Involvement: A Brief Overview of Five Case Reports over 20 Years of Institutional Experience. Diagnostics (Basel) 2020; 10:diagnostics10030168. [PMID: 32245068 PMCID: PMC7151349 DOI: 10.3390/diagnostics10030168] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 03/17/2020] [Accepted: 03/17/2020] [Indexed: 11/16/2022] Open
Abstract
Multiple primary malignant tumors are defined by the development of more than one malignancy in a single patient. These can be subdivided into synchronous or metachronous malignant tumors, depending on their time of appearance, relative to the first malignancy. Triple primary malignancies are a relatively rare occurrence in day-to-day practice and triple synchronous or metachronous carcinomas involving a thyroid localization are even less common. In this case series, we report our 20-year experience in diagnosing and managing five patients with triple malignant tumors with thyroid involvement.
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8
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Vetshev FP, Shpot EV, Khorobrykh TV, Osminin SV, Dymov AM, Proskura AV. [Simultaneous laparoscopic procedures in patients with synchronous multiple primary gastric and kidney cancer]. Khirurgiia (Mosk) 2020:27-31. [PMID: 33301250 DOI: 10.17116/hirurgia202012127] [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] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To evaluate an effectiveness of simultaneous laparoscopic procedures in patients with synchronous multiple primary cancer (SMPC). MATERIAL AND METHODS We observed 3 patients (2 men and 1 woman) aged 61-78 years with synchronous multiple primary gastric and kidney cancer. Gastric tumors were localized in the lower third of the body (1) and the antrum (2), histological structure corresponded to adenocarcinoma G1 (1) and G2 (2). Kidney tumors were verified as light cell carcinoma and localized in the upper segment of the left kidney in 2 patient and right kidney in one patient. Mean dimension of tumor scheduled for resection was 4.65 cm, nephrectomy - 10.3 cm. Complexity of resection according to the RENAL scale was equal to 8 and 10. RESULTS Three patients underwent laparoscopic Billroth-I distal gastrectomy, 2 - kidney resection and one patient - nephrectomy. Mean surgery time was 265±37 min, blood loss - 175±29 ml. There were no conversion and redo interventions within 30 days after surgery. Mean hospital-stay was 11±2 days. CONCLUSION Minimally invasive technologies in patients with SMPC reduces blood loss, ICU- and hospital-stay. Earlier rehabilitation ensures the next stage of treatment in early postoperative period, while quality of life is better in comparison with traditional interventions.
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Affiliation(s)
- F P Vetshev
- Petrovsky National Research Center of Surgery, Moscow, Russia
| | - E V Shpot
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - T V Khorobrykh
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - S V Osminin
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - A M Dymov
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - A V Proskura
- Sechenov First Moscow State Medical University, Moscow, Russia
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9
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Hu MN, Lv W, Hu RY, Si YF, Lu XW, Deng YJ, Deng H. Synchronous multiple primary gastrointestinal cancers with CDH1 mutations: A case report. World J Clin Cases 2019; 7:1703-1710. [PMID: 31367630 PMCID: PMC6658371 DOI: 10.12998/wjcc.v7.i13.1703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 04/22/2019] [Accepted: 05/03/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Synchronous multiple primary cancers (SMPC) mean two or more malignant tumors occurring simultaneously and with different origins no matter what types they are or where they are located. The carcinogenesis of SMPC often involves variations of some specific genes. However, the correlation between CDH1 mutations and synchronous multiple primary gastrointestinal cancers is largely unknown.
CASE SUMMARY A 62-year-old woman had sustained abdominal pain for one week and visited our hospital. Gastrointestinal endoscopy revealed multiple small polypoid lesions in both the stomach and colorectum. Computed tomography and laboratory results were within normal limits. Pathological evaluation confirmed signet ring cell carcinoma without obvious metastatic evidence. Malignant cells showed negativity for E-cadherin and positivity for β-catenin in the cytoplasm and nucleus. DNA sequencing performed on paraffin-embedded tissue revealed two exactly coincident alterations in CDH1, C.57T>G and C.1418A>T.
CONCLUSION This case suggests that the combination of CDH1 mutations and WNT/β-catenin signaling activation contributes to the carcinogenesis of gastrointestinal SMPC.
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Affiliation(s)
- Mu-Ni Hu
- Medical College, Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Wei Lv
- Medical College, Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Rui-Yue Hu
- Department of Pharmacology, Jiangxi Provincial People’s Hospital, Nanchang 330006, Jiangxi Province, China
| | - Yi-Fan Si
- Department of Gastroenterology, the Fourth Affiliated Hospital of Nanchang University, Nanchang 330003, Jiangxi Province, China
| | - Xiao-Wen Lu
- Department of Radiology, the Fourth Affiliated Hospital of Nanchang University, Nanchang 330003, Jiangxi Province, China
| | - Yan-Juan Deng
- Department of Pathology, the Fourth Affiliated Hospital of Nanchang University, Nanchang 330003, Jiangxi Province, China
| | - Huan Deng
- Department of Pathology, the Fourth Affiliated Hospital of Nanchang University, Nanchang 330003, Jiangxi Province, China
- Molecular Medicine and Genetics Center, the Fourth Affiliated Hospital of Nanchang University, Nanchang 330003, Jiangxi Province, China
- Renmin Institute of Forensic Medicine in Jiangxi, Nanchang 330006, Jiangxi Province, China
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10
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Kim SH, Park BS, Kim HS, Kim JH. Synchronous quintuple primary gastrointestinal tract malignancies: Case report. World J Gastroenterol 2017; 23:173-177. [PMID: 28104993 PMCID: PMC5221281 DOI: 10.3748/wjg.v23.i1.173] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 10/05/2016] [Accepted: 10/31/2016] [Indexed: 02/06/2023] Open
Abstract
Multiple primary malignancy is defined as two or more malignancies detected in an individual person. In particular, synchronous quintuple primary malignancy is extremely rare. A 52-year-old male with anal pain and intermittent blood-tinged stool was diagnosed with malignancies in the stomach, jejunum, ascending colon, transverse colon and rectum. He underwent a subtotal gastrectomy, segmental resection of the jejunum and total protocolectomy with end ileostomy. The postoperative pathologic findings were moderate differentiated gastric adenocarcinoma (pT1bN0M0, pStageIA), combined adenocarcinoma and neuroendocrine carcinoma of the jejunum (pT3N0M0, pStageIIA), three mucinous adenocarcinoma of the ascending colon (pT3N0M0, pStageIIA), transverse colon (pT1N0M0, pStageI) and rectum (pT3N1aM0, pStageIIIB). The tumors did not lack MLH-1 and MSH-2 expression, as the markers (bat26, D5S346, bat25, D2S123) suggest MSI-H presence. Adjuvant chemoradiotherapy was started according to regimen, FOLFOX 4 for advanced rectal cancer. Six years post-operation, the patient is currently attending regular follow-ups without recurrence or metastasis.
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MESH Headings
- Adenocarcinoma, Mucinous/diagnosis
- Adenocarcinoma, Mucinous/genetics
- Adenocarcinoma, Mucinous/pathology
- Adenocarcinoma, Mucinous/therapy
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/analysis
- Cancer Pain/etiology
- Chemoradiotherapy, Adjuvant
- Colectomy
- Colonic Neoplasms/diagnosis
- Colonic Neoplasms/genetics
- Colonic Neoplasms/pathology
- Colonic Neoplasms/therapy
- Endoscopy, Gastrointestinal
- Fluorouracil/therapeutic use
- Gastrectomy/methods
- Gastrointestinal Hemorrhage/etiology
- Humans
- Ileostomy
- Jejunal Neoplasms/diagnosis
- Jejunal Neoplasms/genetics
- Jejunal Neoplasms/pathology
- Jejunal Neoplasms/therapy
- Leucovorin/therapeutic use
- Male
- Microsatellite Instability
- Middle Aged
- Neoplasm Staging
- Neoplasms, Multiple Primary/diagnosis
- Neoplasms, Multiple Primary/genetics
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/therapy
- Organoplatinum Compounds/therapeutic use
- Positron Emission Tomography Computed Tomography
- Rectal Neoplasms/diagnosis
- Rectal Neoplasms/genetics
- Rectal Neoplasms/pathology
- Rectal Neoplasms/therapy
- Stomach Neoplasms/diagnosis
- Stomach Neoplasms/genetics
- Stomach Neoplasms/pathology
- Stomach Neoplasms/therapy
- Tomography, X-Ray Computed
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Synchronous Fibrolamellar Hepatocellular Carcinoma and Auricular Myxoma. Case Rep Pathol 2015; 2015:241708. [PMID: 26509093 PMCID: PMC4609791 DOI: 10.1155/2015/241708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 09/03/2015] [Indexed: 02/06/2023] Open
Abstract
Synchronic occurrence of benign and malignant tumors is extremely rare. Fibrolamellar hepatocellular carcinoma represents 1% to 2% of all hepatocarcinomas, while myxomas represent about half of all the cases of primary tumors of the heart. We present the case of a 53-year-old woman with a left atrial myxoma that was surgically removed. Several weeks later, the patient returned to the hospital with abdominal pain. CT scan showed a mass in the left lobe of the liver that was resected and diagnosed as fibrolamellar hepatocellular carcinoma. As of this writing, the patient is healthy.
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