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Stojiljković D, Cvetković A, Jokić A, Mirčić D, Mihajlović S, Krivokuća A, Crnogorac MĐ, Glisic L. Li-Fraumeni Syndrome With Six Primary Tumors-Case Report. Case Rep Oncol Med 2024; 2024:6699698. [PMID: 38765733 PMCID: PMC11101246 DOI: 10.1155/2024/6699698] [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: 11/10/2023] [Revised: 03/06/2024] [Accepted: 03/23/2024] [Indexed: 05/22/2024] Open
Abstract
Li-Fraumeni syndrome (LFS) is a cancer predisposition syndrome associated with a high, lifetime risk of a broad spectrum of cancers caused by pathogenic germline TP53 mutations. Numerous different germline TP53 mutations have been associated with LFS, which has an exceptionally diverse clinical spectrum in terms of tumor type and age of onset. Our patient has developed six asynchronous tumors to date: a phyllode tumor of the breast, a pheochromocytoma, a rosette-forming glioneuronal tumor (RGNT), an adrenocortical carcinoma (ACC), a ductal carcinoma of the breast, and a thymoma. The occurrence of such a number of rare tumors is sporadic even among in the population of patients living with cancer predisposition syndromes. In this instance, the omission of pretest genetic counseling and thorough family tree analysis prior to selecting the test led to the oversight of an underlying TP53 likely pathogenic mutation (classified as Class 4). This emphasizes the necessity for such counseling to prevent overlooking crucial genetic information. Neglecting this step could have had profound implications on the patient's treatment, particularly considering the early onset and occurrence of multiple tumors, which typically raise suspicion of a hereditary component. The implications for family members must be considered.
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Affiliation(s)
- Dejan Stojiljković
- Department of Surgery, Surgical Oncology Clinic, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ana Cvetković
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Department of Anesthesiology With Reanimatology and Intensive Care Unit, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Andrej Jokić
- Department of Anesthesiology With Reanimatology and Intensive Care Unit, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Dijana Mirčić
- Department of Anesthesiology With Reanimatology and Intensive Care Unit, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Sanja Mihajlović
- Department of Surgery, Surgical Oncology Clinic, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Ana Krivokuća
- Department for Experimental Research and Genetics, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Marija Đorđić Crnogorac
- Department for Experimental Research and Genetics, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Lazar Glisic
- Department of Obstetrics and Gynecology, University Clinic Ulm, Faculty of Medicine, University of Ulm, Ulm, Germany
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2
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Kim SH, Baek YB, Park SI. Canine multiple primary tumours: Mammary tubular carcinoma, uterine leiomyosarcoma, and facial sebaceous epithelioma. VET MED-CZECH 2024; 69:94-98. [PMID: 38623156 PMCID: PMC11016304 DOI: 10.17221/103/2023-vetmed] [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: 10/06/2023] [Accepted: 02/14/2024] [Indexed: 04/17/2024] Open
Abstract
Multiple primary malignant tumours (MPMTs) are multiple neoplasms with independent pathogenetic origins, placing great importance on the tumorigenesis and clinical treatment. However, due to the rare occurrence and diagnostic confusion, MPMTs have rarely been investigated in veterinary medicine. In this report, a 10-year-old intact female Maltese dog had MPMTs, consisting of two malignant tumours and one benign tumour each derived from a topographically different site: tubular carcinoma in the mammary glands, leiomyosarcoma in the uterus and sebaceous epithelioma in the cheek. The unique combination of MPMTs would be the first case in veterinary research to give insight into the diagnosis, disease characteristics, and surgical treatment.
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Affiliation(s)
- Seung-Hyun Kim
- Laboratory of Veterinary Surgery, College of Veterinary Medicine, Chonnam National University, Gwangju, Republic of Korea
| | - Yeong-Bin Baek
- Laboratory of Veterinary Pathology, College of Veterinary Medicine, Chonnam National University, Gwangju, Republic of Korea
| | - Sang-Ik Park
- Laboratory of Veterinary Pathology, College of Veterinary Medicine, Chonnam National University, Gwangju, Republic of Korea; College of Veterinary Medicine and BK21 FOUR Program, Chonnam National University, Gwangju, Republic of Korea
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3
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Hao L, Zhang L, Xu C, Jiang M, Zhu G, Guo J. Multiple synchronous primary malignant neoplasms: A case report and literature review. Oncol Lett 2023; 26:428. [PMID: 37664660 PMCID: PMC10472045 DOI: 10.3892/ol.2023.14014] [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: 03/27/2023] [Accepted: 07/13/2023] [Indexed: 09/05/2023] Open
Abstract
Multiple primary malignant neoplasms (MPMN) are defined as two or more primary malignancies diagnosed in an individual. There is no association between these cancers, which can be classified into synchronous and heterochronous cancers depending on the time of diagnosis. The present study presented a rare case of bilateral breast, endometrial, cervical and ovarian cancers. Through thorough physical examination, pathology and immunohistochemistry, it could be determined that bilateral breast, endometrial and cervical cancers were primary malignant tumors and that ovarian cancer cannot be excluded as a result of metastasis. the present study also summarized the definitions, risk factors, prevalence characteristics, diagnostic ideas and treatment options for MPMN by reviewing the literature.
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Affiliation(s)
- Linlin Hao
- Department of Tumor Radiotherapy, The Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
| | - Lihui Zhang
- Department of Gynaecology, The Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
| | - Chuanjie Xu
- Department of Pathology, The Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
| | - Min Jiang
- Department of Tumor Radiotherapy, The Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
| | - Geyi Zhu
- Department of Tumor Radiotherapy, The Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
| | - Jie Guo
- Department of Tumor Radiotherapy, The Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China
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4
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Xiao L, Cao T, Ou J, Liang W. Clinical characteristics and prognostic analysis of multiple primary malignant neoplasms in female patients with breast cancer or genitalia malignancies. PeerJ 2022; 10:e13528. [PMID: 35769138 PMCID: PMC9235813 DOI: 10.7717/peerj.13528] [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: 01/10/2022] [Accepted: 05/11/2022] [Indexed: 01/17/2023] Open
Abstract
Background As public awareness of health has increased and diagnostic and treatment options have improved, the survival of patients with malignant tumors has continued to extend, and the population has been aging, the number of multiple primary malignant neoplasms has gradually increased in recent years. There are few reports concerning female patients with multiple primary malignant neoplasms of breast cancer or genitalia malignancies. In this study, we aimed to analyze the clinical characteristics and prognosis of multiple primary malignant neoplasms in female patients with breast cancer or genitalia malignancies, as well as further explore the factors that affect the survival. Methods We collected clinical data on 80 female patients diagnosed with multiple primary malignant neoplasms of the breast or genitalia, described their clinical features. Furthermore, we calculated the survival and prognostic factors for 52 participants. Results In our study, the prevalence rate of multiple primary malignant neoplasms was 0.66% (367/55404). Corresponding to female patients with multiple primary malignant neoplasms of breast cancer or genitalia malignancies, it was 1.4% (80/5707). the median age of diagnosis for the first tumor was 48 years, and the median age of diagnosis for the second tumor was 52 years. Regarding the interval, 67.57% (50/74) of patients were within five years. Most tumors were located in the breast (44.68%), followed by the uterus (20.21%), the ovary (17.02%), and the cervix (15.96%). The overall 12-, 36-and 60-month survival rates of the patients were 86.4%, 74.3%, and 69.8%. For the female patients, the stage (III-IV) (P = 0.046), non-radical surgery (P = 0.002), and types of the last tumor (breast cancer or genitalia malignancies) (P = 0.019) were associated with the poor prognosis. Conclusions Female patients with breast cancer or genital malignancies should pay attention to screening for the second tumor, especially within 4 years after the first tumor diagnosed. Furthermore, during tumor screening, it may be recommended for these patients to focus on colorectal cancer and lung cancer. Compared with previous studies, in addition to clinical staging and types of surgery, we found whether the last tumor was breast cancer or genitalia malignancies should also be considered a prognostic factor.
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Affiliation(s)
- Li Xiao
- Medical Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Tiantian Cao
- Intensive Care Unit, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiali Ou
- Medical Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Weijiang Liang
- Medical Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
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5
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Tripodi D, Cannistra' C, Gagliardi F, Casella G, Lauro A, De Luca A, Amabile MI, Palumbo P, Pironi D, Mascagni D, D'Andrea V, Vergine M, Sorrenti S. Coincidental or Causal? Concurrence of Colorectal Carcinoma with Primary Breast Cancer. Dig Dis Sci 2022; 67:437-444. [PMID: 34731362 DOI: 10.1007/s10620-021-07296-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/06/2021] [Indexed: 12/12/2022]
Abstract
Multiple primary malignant neoplasms (MPMN) represent the occurrence of a second malignancy in the same patient within 6 months after the detection of first primary (synchronous) tumor, or > 6 months after primary detection (metachronous). We present a case of a patient treated for carcinoma of the breast who developed a metachronous primary malignancy in the colorectal tract. These tumors were histologically different with distinct immune-histochemical parameters. The association between breast and colon cancer is well documented in the literature with several studies reporting the coexistence of common extrinsic and genetic predisposing factors. Although rare, MPMN are becoming more common due to the increased number of elderly cancer survivors, improved diagnosis and enhanced awareness. The association between colorectal and breast cancer should not be dismissed merely as metastasis since there is good precedent for the co-occurrence of these primary tumors.
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Affiliation(s)
- Domenico Tripodi
- Department of Surgical Sciences, Sapienza University, Rome, Italy.
| | - Claudio Cannistra'
- Department of General Surgery, Bichat C. B. University Hospital, Paris, France
| | | | - Giovanni Casella
- Department of Surgical Sciences, Sapienza University, Rome, Italy
| | - Augusto Lauro
- Department of Surgical Sciences, Sapienza University, Rome, Italy
| | | | | | | | - Daniele Pironi
- Department of Surgical Sciences, Sapienza University, Rome, Italy
| | | | - Vito D'Andrea
- Department of Surgical Sciences, Sapienza University, Rome, Italy
| | - Massimo Vergine
- Department of Surgical Sciences, Sapienza University, Rome, Italy
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Primary Adenocarcinoma of Lung with Synchronous Renal Cell Carcinoma: A Case Report and Review of the Literature. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2020. [DOI: 10.5812/ijcm.109379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: The simultaneous occurrence of two distinct tumors is rare. Distinguishing between the concomitances of two primary malignancies from metastatic disease is very important for disease management and overall survival improvement. Case Presentation: We report a case of a lung adenocarcinoma patient, who incidentally has renal cell carcinoma (RCC). This report includes clinical, radiological, and histological diagnostic challenges in an unexpected lesion and a review of the literature. Conclusions: The possibility of primary cancer should be taken into account when a lesion is detected in the lung or the kidneys. Thus, both the radiographic appearance and clinical behavior of a lesion may hold clues that can help distinguish synchronous cancers.
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7
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Hwang KT, Kim MJ, Chu AJ, Park JH, Kim J, Lee JY, Choi IS, Park JH, Chang JH, Hwang KR. Metachronous Sporadic Sextuple Primary Malignancies Including Bilateral Breast Cancers. J Breast Cancer 2020; 23:438-446. [PMID: 32908793 PMCID: PMC7462815 DOI: 10.4048/jbc.2020.23.e21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 03/11/2020] [Indexed: 01/22/2023] Open
Abstract
Multiple primary malignancies are defined as the presence of more than one malignant neoplasm with a distinct histology occurring at different sites in the same individual. They are classified as synchronous or metachronous according to the diagnostic time interval of different malignancies. Diagnosis of multiple primary malignancies should avoid misclassification from multifocal/multicentric tumors or recurrent/metastatic lesions. In multiple primary malignancies, with increase in the number of primary tumors, the frequency rapidly decreases. Here, we report an exceptionally rare case of a woman who was diagnosed with metachronous sporadic sextuple primary malignancies including bilateral breast cancers (gastric cancer, ovarian Sertoli-Leydig cell tumor, left breast cancer, thyroid cancer, right breast cancer, and rectal neuroendocrine tumor). The sextuple primary malignancies in this case involved 5 different organs: the stomach, ovary, thyroid, rectum, and bilateral breasts. Further studies are needed to elucidate the current epidemiologic status of patients with multiple primary malignancies.
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Affiliation(s)
- Ki-Tae Hwang
- Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Myong Jin Kim
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - A Jung Chu
- Department of Radiology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jeong Hwan Park
- Department of Pathology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jongjin Kim
- Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jong Yoon Lee
- Department of Radiology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - In Sil Choi
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jin Hyun Park
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Ji Hyun Chang
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea
| | - Kyu Ri Hwang
- Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
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8
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De Luca A, Frusone F, Vergine M, Cocchiara R, La Torre G, Ballesio L, Monti M, Amabile MI. Breast Cancer and Multiple Primary Malignant Tumors: Case Report and Review of the Literature. In Vivo 2019; 33:1313-1324. [PMID: 31280224 DOI: 10.21873/invivo.11605] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 05/24/2019] [Accepted: 05/28/2019] [Indexed: 12/13/2022]
Abstract
Multiple primary malignant neoplasms are multiple tumors with different pathogenetic origin. They may be synchronous or metachronous. The management of these conditions represents an interesting clinical scenario. A crucial aspect is the decision regarding which tumor to treat initially, and how to schedule further treatments according to individual tumor risk. This process involves a multidisciplinary physician team to ensure favorable outcomes. We describe a case report of a female patient affected by primary synchronous tumors of the breast and pectoral skin, which raised a series of diagnostic, etiological and therapeutic issues persuading us to carry out a critical review of the literature.
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Affiliation(s)
- Alessandro De Luca
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Federico Frusone
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Massimo Vergine
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Rosario Cocchiara
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Laura Ballesio
- Department of Radiology, Anatomo-Pathology and Oncology, Sapienza University of Rome, Rome, Italy
| | - Massimo Monti
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - Maria Ida Amabile
- Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
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9
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Zhang L, Feng L, Cong H, Yu Z, Wang H, Dong Y, Wang J. Multiple primary malignant neoplasms: A case report and literature review. Oncol Lett 2019; 18:4210-4220. [PMID: 31579423 PMCID: PMC6757307 DOI: 10.3892/ol.2019.10779] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 07/09/2019] [Indexed: 12/18/2022] Open
Abstract
Until recently, few cases of three or more malignant tumors in one patient have been reported. Owing to the high incidence rate of these tumors, the improvement in cancer diagnosis and treatment, and the extension of patient survival time, the incidence of reported multiple primary malignant neoplasms has gradually increased. The present study reported the case of a 57-year-old man with non-small cell lung cancer combined with B-Raf proto-oncogene serine/threonine kinase V600E mutation, gastrointestinal stromal tumors and lumbar vertebral malignant mucinous sarcoma. The pathogenesis, diagnosis and treatment of these three malignancies are discussed and previous studies are also reviewed. The aim of the study was to analyze the genetic mutations associated with multiple primary malignant tumors and to discuss whether those mutations with unknown functional significance could be used as therapeutic indicators. This case report will serve as a reference for future treatment of such patients.
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Affiliation(s)
- Linwei Zhang
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Lingxin Feng
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Hui Cong
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Zhuang Yu
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Haocheng Wang
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Ya Dong
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - Jing Wang
- Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266000, P.R. China
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10
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White R, Otaibi Z, Rao R, Finley G. BRAF V600E Mutation in Multiple Primary Malignancies: A Hairy Affair. Cureus 2018; 10:e3600. [PMID: 30680261 PMCID: PMC6338405 DOI: 10.7759/cureus.3600] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
As the number of cancer survivors grows, so does the number of co-occurring primary malignancies and secondary malignancies. In rare cases, single driver mutations can be responsible for concomitant primary malignancies. By understanding the mechanisms that drive multiple primary malignancies (MPM), clinicians are capable of targeting molecular pathways that drive oncogenesis resulting in the successful treatment of many malignancies while also reducing the side effects of conventional chemotherapy. Herein, we report a case of co-occurring hairy cell leukemia (HCL) and malignant melanoma in a 69-year-old male. This patient tested positive for the BRAF V600E mutation and was initiated on a single agent, vemurafenib. He, unfortunately, succumbed to his illness before completion of his planned therapy course. This case report is intended to highlight the rare co-occurrence of BRAF-positive HCL and melanoma and to encourage driver mutation evaluation when a patient presents with MPM and the possibility of a unifying driver mutation. To the best of our knowledge, this is the first case of a co-occurring BRAF positive melanoma and HCL to be reported in a chemotherapy-naïve patient.
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Affiliation(s)
- Richard White
- Internal Medicine, Allegheny Health Network, Pittsburgh, USA
| | - Zachary Otaibi
- Hematology & Oncology, Allegheny Health Network, Pittsburgh, USA
| | - Rohit Rao
- Hematology & Oncology, Allegheny Health Network, Pittsburgh, USA
| | - Gene Finley
- Hematology & Oncology, Allegheny Health Network, Pittsburgh, USA
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11
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Danys D, Stratilatovas E, Cereska V, Poskus T. Lynch syndrome and sextuple primary malignancies. Acta Chir Belg 2018; 118:326-330. [PMID: 28938854 DOI: 10.1080/00015458.2017.1379801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Lynch syndrome or hereditary nonpolyposis colorectal cancer is the most common of hereditary colorectal cancer and accounts for 1-3%. Lynch and Chapelle estimated that it accounts 5-8% for all colorectal cancers. It is an autosomal dominant syndrome characterized by predisposition of various cancers (colorectal, stomach, endometrial, ovarian, renal, small bowel, and hepatobiliary tract) at earlier age than in general population and occurs as a result of mutation in DNA mismatch repair genes. This article presents a rare clinical of a 61-year-old female diagnosed with extracolonic Lynch syndrome with six metachronous tumours acquiring in digestive tract during the period from 1993 to 2014 (over 21 years). No other cases of six primary malignancies in patient with Lynch syndrome have been reported in literature. Upon diagnosis of Lynch syndrome, it is important to screen patient for malignancies of different localization as this syndrome predisposes appearance of various cancers at earlier age than in general population.
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Affiliation(s)
- Donatas Danys
- Center of Abdominal Surgery, Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania
| | - Eugenijus Stratilatovas
- Center of Abdominal Surgery, Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania
| | | | - Tomas Poskus
- Center of Abdominal Surgery, Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania
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12
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N Dilek O, Ozsay O, Karaisli S, Ö Gür E, Er A, G Haciyanli S, Kar H, H Dilek F. Striking Multiple Primary Tumors that underwent Whipple Procedure due to Periampullary Carcinoma: An Analysis of 21 Cases. Euroasian J Hepatogastroenterol 2018; 8:1-5. [PMID: 29963453 PMCID: PMC6024055 DOI: 10.5005/jp-journals-10018-1249] [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: 12/12/2017] [Accepted: 01/12/2018] [Indexed: 11/23/2022] Open
Abstract
Introduction The term multiple primary tumor (MPT) is used to describe cases where two or more primary tumors show no histopathological similarities in between. Multiple primary tumor cases have begun to increase in recent years as a result of the increase in life expectancy because of the increase in life standards and progress in diagnostic methods. In this study, MPT cases with periampullary tumors that underwent Whipple procedure were discussed in the light of literature data. Materials and methods The patient files of 223 cases with periampullary tumors that underwent Whipple procedure in our hospital during the last 6 years were examined retrospectively. More than one primary tumor was detected in 21 patients. Results Periampullary carcinomas were detected as a second primary tumor in 18 patients. First primary tumor was periampullary carcinoma in 3 patients that underwent Whipple procedure. After the Whipple procedure, 5 patients died due to early complications in the first 30 days and 6 patients died due to metastases and additional problems that developed during follow-up. Discussion The incidence of MPT has been reported as 0.7 to 14.5% in the literature. Most of them are multiple primary case presentations. In patient management, it is recommended that each tumor should be evaluated independently of its own characteristics, and treatment and follow-up should be planned accordingly. Conclusion The MPT cases are increasing. The possibility of MPT as well as metastasis should be kept in mind during the evaluation of tumor foci seen during diagnosis and follow-up of patients. The characteristics of each tumor, survival, and prognosis should be evaluated separately and the most appropriate treatment should be offered to the patient. It is recommended that synchronic primary tumors which are considered to be surgically resectable without metastasis should be removed in the same session.How to cite this article: Dilek ON, Ozsay O, Karaisli S, Gür EÖ, Er A, Haciyanli SG, Kar H, Dilek FH. Striking Multiple Primary Tumors that underwent Whipple Procedure due to Periampullary Carcinoma: An Analysis of 21 Cases. Euroasian J Hepato-Gastroenterol 2018;8(1):1-5.
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Affiliation(s)
- Osman N Dilek
- Department of Surgery, Izmir Katip Çelebi University School of Medicine, Izmir, Turkey
| | - Oguzhan Ozsay
- Department of Surgery, Izmir Katip Çelebi University School of Medicine, Izmir, Turkey
| | - Serkan Karaisli
- Department of Surgery, Izmir Katip Çelebi University School of Medicine, Izmir, Turkey
| | - Emine Ö Gür
- Department of Surgery, Izmir Katip Çelebi University School of Medicine, Izmir, Turkey
| | - Ahmet Er
- Department of Surgery, Izmir Katip Çelebi University School of Medicine, Izmir, Turkey
| | - Selda G Haciyanli
- Department of Surgery, Izmir Katip Çelebi University School of Medicine, Izmir, Turkey
| | - Haldun Kar
- Department of Surgery, Izmir Katip Çelebi University School of Medicine, Izmir, Turkey
| | - Fatma H Dilek
- Department of Pathology, Izmir Katip Çelebi University, Ataturk Research and Education Hospital, Izmir, Turkey
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13
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Arakawa K, Hata K, Yamamoto Y, Nishikawa T, Tanaka T, Kiyomatsu T, Kawai K, Nozawa H, Yoshida M, Fukuhara H, Fujishiro M, Morikawa T, Yamasoba T, Koike K, Fukayama M, Watanabe T. Nine primary malignant neoplasms-involving the esophagus, stomach, colon, rectum, prostate, and external ear canal-without microsatellite instability: a case report. BMC Cancer 2018; 18:24. [PMID: 29301504 PMCID: PMC5753511 DOI: 10.1186/s12885-017-3973-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 12/21/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Although cases of multiple primary malignant neoplasms are increasing, reports of more than three or four primary metachronous malignant neoplasms are extremely rare. Moreover, very few publications have provided a genetic mutational analysis or have evaluated risk factors associated with such neoplasms. We present an extremely rare case of nine primary malignant lesions in a man who was successfully treated. We also report on microsatellite stability status, analyze risk factors, and discuss the relevant literature. CASE PRESENTATION Between 67 and 73 years of age, a male patient developed nine primary metachronous malignant lesions: Three were located in the esophagus, two in the stomach, two in the colorectum, one in the prostate gland, and one in the external ear canal. The patient's clinical history included hypertension, atrial fibrillation, an acoustic schwannoma, and heavy smoking. The lesions were diagnosed during regular screening over a six-year period. He was successfully treated with surgery (both open surgical and endoscopic resection of lesions) and adjuvant chemotherapy. Immunohistochemistry and mutational analysis showed that the lesions were microsatellite stable, and the KRAS, BRAF, p53, and nuclear β-catenin status was not uniform among the lesions. CONCLUSIONS Given that the presence of more than three or four neoplasms is extremely rare, the present case of nine primary malignancies with no associated microsatellite instability and no apparent predisposing hereditary conditions, is extraordinary. Our case study shows that it is possible for up to nine sporadic neoplasms to occur, and efficient disease management requires diligent screening and early detection.
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Affiliation(s)
- Keiichi Arakawa
- Department of Surgical Oncology, the University of Tokyo, Tokyo, Japan
- Department of Surgical Oncology, University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Keisuke Hata
- Department of Surgical Oncology, the University of Tokyo, Tokyo, Japan
| | - Yoko Yamamoto
- Department of Surgical Oncology, the University of Tokyo, Tokyo, Japan
| | - Takeshi Nishikawa
- Department of Surgical Oncology, the University of Tokyo, Tokyo, Japan
| | - Toshiaki Tanaka
- Department of Surgical Oncology, the University of Tokyo, Tokyo, Japan
| | | | - Kazushige Kawai
- Department of Surgical Oncology, the University of Tokyo, Tokyo, Japan
| | - Hiroaki Nozawa
- Department of Surgical Oncology, the University of Tokyo, Tokyo, Japan
| | - Masafumi Yoshida
- Department of Otolaryngology, the University of Tokyo, Tokyo, Japan
| | | | | | - Teppei Morikawa
- Department of Pathology, the University of Tokyo, Tokyo, Japan
| | - Tatsuya Yamasoba
- Department of Otolaryngology, the University of Tokyo, Tokyo, Japan
| | - Kazuhiko Koike
- Department of Gastroenterology, the University of Tokyo, Tokyo, Japan
| | | | - Toshiaki Watanabe
- Department of Surgical Oncology, the University of Tokyo, Tokyo, Japan
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14
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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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15
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Nyqvist J, Persson F, Parris TZ, Helou K, Kenne Sarenmalm E, Einbeigi Z, Borg Å, Karlsson P, Kovács A. Metachronous and Synchronous Occurrence of 5 Primary Malignancies in a Female Patient between 1997 and 2013: A Case Report with Germline and Somatic Genetic Analysis. Case Rep Oncol 2017; 10:1006-1012. [PMID: 29279706 PMCID: PMC5731098 DOI: 10.1159/000484403] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 10/18/2017] [Indexed: 12/15/2022] Open
Abstract
The number of patients with multiple primary malignancies has been increasing steadily in recent years. In the present study, we describe a unique case of an 81-year-old woman with 5 metachronous and synchronous primary malignant neoplasms. The patient was first diagnosed with an endometrium adenocarcinoma in 1997 and a colon adenocarcinoma in 2002. Eleven years after her colon surgery, in 2013, the patient presented with 3 other primary malignancies within a 4-month time span: an invasive malignant melanoma on the lower leg, an invasive mucinous breast carcinoma in the right breast, and a pleomorphic spindle cell sarcoma on the left upper arm. Subsequent routine medical checkups in 2013–2017 revealed no metastases of the primary malignancies. The patient mentioned a familial aggregation of malignant tumors, including 2 sisters with breast cancer and a brother with lung cancer. Interestingly, next-generation sequencing analysis of the patient's blood sample detected no mutations in the BRCA1, BRCA2, TP53, PTEN, CDH1, PALB2, RAD51C, RAD51D, MLH1, MSH2, MSH6, PMS2, EPCAM, APC, MUTYH, STK11, BMPR1A, SMAD4, PTEN, POLE, POLD1, GREM1, and GALNT12 genes. Therefore, whole genome sequencing is warranted to identify cancer-related genetic alterations in this patient with quintuple primary malignancies.
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Affiliation(s)
- Jenny Nyqvist
- Department of Surgery, Skaraborgs Hospital, Lidköping and Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Fredrik Persson
- Department of Clinical Pathology and Genetics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Toshima Z Parris
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Khalil Helou
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Cancer Center, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | | | - Zakaria Einbeigi
- Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Åke Borg
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Per Karlsson
- Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anikó Kovács
- Department of Clinical Pathology and Genetics, Sahlgrenska University Hospital, Gothenburg, Sweden
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