1
|
Iwasaki M, So C, Jinta T. Identification of a TP53 Mutation in a Patient With Li-Fraumeni Syndrome and Not Meeting the Revised Chompret Criteria: A Case Report. Cureus 2023; 15:e40025. [PMID: 37425585 PMCID: PMC10323706 DOI: 10.7759/cureus.40025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 07/11/2023] Open
Abstract
Li-Fraumeni syndrome (LFS) is a rare familial disorder caused by germline TP53 mutations. Despite the establishment of the revised Chompret criteria to guide genetic testing for TP53, identifying LFS in patients who do not satisfy these criteria remains a challenge. Herein, we present the case of a 50-year-old woman with a history of breast, lung, colorectal, and tongue cancers who did not satisfy the revised Chompret criteria. However, genetic testing ultimately revealed a TP53 mutation, leading to the diagnosis of LFS. Although her family history did not satisfy the classic LFS criteria, she had a TP53 core tumor before the age of 46 years. This case highlights the importance of considering LFS in patients with a history of multiple cancers and suggests that genetic testing should be considered even in patients who do not satisfy the revised Chompret criteria.
Collapse
Affiliation(s)
- Monika Iwasaki
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, JPN
| | - Clara So
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, JPN
| | - Torahiko Jinta
- Department of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, JPN
| |
Collapse
|
2
|
Zervoudis S, Iatrakis G, Markja A, Tsatsaris G, Bothou A, von Tempelhoff GF, Balafouta M, Tsikouras P. Risk Factors of Synchronous Breast and Thyroid Cancer: a Controlled Multicenter Study and Review of the Literature. Mater Sociomed 2021; 33:298-303. [PMID: 35210954 PMCID: PMC8812374 DOI: 10.5455/msm.2021.33.298-303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/16/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Breast cancer (BC) is one of the most common cancers diagnosed in women in the United States. Thyroid cancer (TC) is also one of the fastest increasing cancer types in the United States, with most cases being papillary thyroid carcinomas. OBJECTIVE To identify possible risk factors for the synchronous or metachronous co-occurrence of breast and thyroid cancers. METHODS We carried out a study, which consisted of data from four gynecological clinics: two in Greece (Athens, Alexandroupolis, Ioannina) and one in Germany, collected from June 2017 to June 2020. The patients were divided into two groups: the first group consisted of 58 patients with breast cancer and a personal history of thyroid cancer. The second group (control group) included 50 patients with the same characteristics as to age, parity, type of pregnancy, treatment for sterility, polycystic ovaries, regularity of the menstrual cycle, breast density, BMI, family history of cancer, blood group rhesus and histological results of breast cancer. The data we collected were analyzed using version 20 of the SPSS statistical package. The Chi-square test was used for statistical analysis and a p-value<0.005 was considered statistically significant. RESULTS The only factors that seem to be related with the association of breast and thyroid cancer were: history of abortion and multiparity. CONCLUSION In our study there is a higher chance of developing breast cancer after diagnosing thyroid cancer and vice versa. More than genetic mutations, a possible hormonal pathway of these two malignancies is possible. The hormonal change in women who had many children or abortions could be a risk factor to develop both cancers. More studies are necessary to confirm our findings.
Collapse
Affiliation(s)
- Stefanos Zervoudis
- Breast Unit, REA Maternity Hospital, Athens, Greece
- Department of Midwifery, University of West Attica, Athens, Greece
| | | | - Anisa Markja
- Department of Midwifery, University of West Attica, Athens, Greece
| | | | - Anastasia Bothou
- Department of Midwifery, University of West Attica, Athens, Greece
| | | | | | - Pana Tsikouras
- Democritus University of Thrace, Alexandroupolis, Greece
| |
Collapse
|
3
|
Toyofuku A, Iha Y, Koreeda Y, Yoshida K, Higure A, Sasaguri T, Nagata N. [Two Cases of Synchronous Double Primary Prostate Cancer Accompanying Bone Metastasis and Colon Cancer]. J UOEH 2021; 43:103-15. [PMID: 33678780 DOI: 10.7888/juoeh.43.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We report two cases of synchronous double primary cancers, which were composed of prostate cancer accompanied by bone metastasis and colon cancer, within only five months of each other. The first was a 77-year-old man whose ECOG PS was 0. He was referred to our hospital in March 2020 because abdominal CT scan, which was performed at a clinic for the purpose of close examination of poor control of diabetes, showed wall thickening of the sigmoid colon. A further examination revealed prostate cancer accompanied by metastatic bone cancer and sigmoid colon cancer. Laparoscopic sigmoid colectomy was performed in April. Currently, six months after the surgery, both the prostate cancer and its accompanying metastatic bone cancer are well controlled by hormonal therapy. The second case was an 86-year-old man with an ECOG PS of 3 who was brought to our hospital by ambulance in August, 2020 because of fever and abdominal pain. A close examination revealed cecal cancer accompanying acute appendicitis. Prostate cancer accompanied by metastatic bone cancer was also diagnosed. Laparoscopic ileocecal resection was performed in the same month, but, unfortunately, the patient had repeated aspiration pneumonia and he finally passed away 43 days after surgery. We discuss the treatment strategy for colorectal cancer with synchronous or metachronous prostate cancer, which has been increasing in recent years, and include epidemiological considerations.
Collapse
|
4
|
Babu G, Asati V, Lakshmaiah KC, Lokanatha D, Jacob LA, Babu S, Lokesh KN, Rudresh AH, Rajeev LK, Saldanha S, Chethan R, Koppaka D, Premalata CS. Every distant deposit is not a metastasis: Synchronous primaries do exist. Indian J Cancer 2019; 56:70-73. [PMID: 30950449 DOI: 10.4103/ijc.ijc_637_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Synchronous occurrence of two malignant tumors is a rare event. With increasing use of sophisticated imaging modalities for staging, synchronous multiple tumors are more commonly detected now. Assuming the second primary malignancy as metastasis will change the intent of treatment from curative to palliative, greater awareness among oncologists is of paramount importance. This study is an example where thorough clinical examination and proper judgment resulted in correct diagnosis and appropriate treatment. MATERIALS AND METHODS This is a prospective descriptive study. Patients diagnosed with synchronous primary tumors from January 2016 to November 2017 at our center were reviewed. RESULTS Ten cases of synchronous primary malignancies were detected during this period. A total of 20 primary tumors were diagnosed. Lung carcinoma and gastrointestinal malignancies were the most common (five patients each). The median age was 59.5 years. Seven patients were male. Second primary tumor was suspected in four patients during clinical examination, while in six patients it was suspected on imaging. Even in the presence of two primary tumors, three patients were treated with curative intent. CONCLUSION Possibility of synchronous second primary malignancy should always be kept whenever a distant deposit is detected at an unusual site. Histopathological evaluation of the lesion before assuming a metastasis will lead to accurate diagnosis, staging, and appropriate treatment.
Collapse
Affiliation(s)
- Govind Babu
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Vikas Asati
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - K C Lakshmaiah
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - D Lokanatha
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Linu Abraham Jacob
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Suresh Babu
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - K N Lokesh
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - A H Rudresh
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - L K Rajeev
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Smitha Saldanha
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - R Chethan
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - Deepak Koppaka
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| | - C S Premalata
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
| |
Collapse
|
5
|
Norose T, Ohike N, Imai H, Shibata H, Suzuki R, Isobe T, Asonuma K, Kuroki Y, Nagahama M, Tanaka JI, Takimoto M. A case of rectal neuroendocrine carcinoma in a patient with long-standing ulcerative colitis involving alterations of the p16-Rb pathway. Pathol Int 2017; 67:526-530. [PMID: 28851045 DOI: 10.1111/pin.12569] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 07/20/2017] [Indexed: 12/26/2022]
Abstract
The patient was a 54-year-old male who had been suffering from extensive ulcerative colitis (UC) for 17 years. Colonoscopy revealed an elevated lesion in the affected rectum, and its biopsy demonstrated neuroendocrine carcinoma (NEC). The surgical specimen obtained on laparoscopic high anterior resection showed extensive active inflammatory and dysplastic lesions and three grossly visible multifocal malignant lesions: a polypoid fungating tumor of NEC (type 1, 20 mm in diameter, pT3) that had been preoperatively noticed, a polypoid fungating tumor of adenocarcinoma (type 1, 22 mm, pT2) and a protruded sessile polypoid tumor (0-Is, 5 mm, pTis) of adenocarcinoma. The NEC was adjacently accompanied by dysplasia-carcinoma sequential lesions and showed a diffuse immunohistochemical overexpression of p53 and p16 proteins and the loss of Rb with no abnormal immunohistochemical staining of microsatellite instability markers and no KRAS mutations. Fifteen months later, the patient showed liver metastasis from the NEC component, followed by bone and spinal metastasis; he died 22 months after the initial diagnosis. A rare case of lethal NEC arising from long-standing extensive UC was reported. The NEC appeared to be UC-related, not incidental, and complicated by progression from dysplasia to carcinoma involving alterations of the p16-Rb pathway.
Collapse
Affiliation(s)
- Tomoko Norose
- Department of Pathology, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan
| | - Nobuyuki Ohike
- Department of Pathology, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan
| | - Hideyuki Imai
- Department of Pathology, Showa University Hospital, Shinagawa, Tokyo, Japan
| | - Hideki Shibata
- Department of Pathology, Showa University Hospital, Shinagawa, Tokyo, Japan
| | - Reika Suzuki
- Department of Pathology, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan
| | - Tomohide Isobe
- Department of Pathology, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan
| | - Kunio Asonuma
- Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan
| | - Yuichiro Kuroki
- Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan
| | - Masatsugu Nagahama
- Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan
| | - Jun-Ichi Tanaka
- Department of Gastroenterological and General Surgery, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan
| | - Masafumi Takimoto
- Department of Pathology, Showa University Hospital, Shinagawa, Tokyo, Japan
| |
Collapse
|
6
|
OTOWA YASUNORI, NAKAMURA TETSU, TAKIGUCHI GOSUKE, URAKAWA NAOKI, ISHIDA RYO, IMANISHI TATSUYA, SUZUKI SATOSHI, TANAKA KENICHI, KURODA DAISUKE, KAKEJI YOSHIHIRO. Successful treatment of quintuple primary cancer, including esophageal cancer: A case report. Oncol Lett 2015; 9:2583-2585. [PMID: 26137110 PMCID: PMC4473657 DOI: 10.3892/ol.2015.3082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 02/11/2015] [Indexed: 11/05/2022] Open
Abstract
The present study reports the rare case of a patient with quintuple primary cancer that underwent systematic treatment, including surgical intervention. A 63-year-old male patient was initially diagnosed with primary esophageal cancer and hypopharyngeal cancer. The patient underwent total pharyngolaryngoesophagectomy using a thoracoscopic method and reconstruction using the free jejunal flap and gastric tube and was subsequently administered adjuvant chemotherapy (80 mg/m2 intravenously on day 1, cisplatin; 800 mg/m2 continuous intravenous administration on days 1-5, 5-fluorouracil). At 66 years old, the patient was diagnosed with left maxillary sinus cancer and underwent chemoradiotherapy (four 100 mg/m2 arterial cisplatin injections; 70 Gy/35 f radiotherapy, 2 Gy per day over 35 days). At 68 years old, the patient was diagnosed with gastric tube cancer and underwent gastric tube resection followed by pedicled jejunum flap reconstruction. At 69 years old, the patient was diagnosed with tongue cancer and underwent resection and reconstruction of the tongue by pectoralis major myocutaneous flap. Six years subsequent to the primary surgery, the patient remains alive, without metastasis of the lesions. To the best of our knowledge, the present study is the first report of a patient that underwent a curative procedure for the treatment of five primary multiple cancers in five organs, including esophageal cancer.
Collapse
Affiliation(s)
- YASUNORI OTOWA
- Department of Surgery, Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - TETSU NAKAMURA
- Department of Surgery, Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - GOSUKE TAKIGUCHI
- Department of Surgery, Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - NAOKI URAKAWA
- Department of Surgery, Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - RYO ISHIDA
- Department of Surgery, Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - TATSUYA IMANISHI
- Department of Surgery, Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - SATOSHI SUZUKI
- Department of Surgery, Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - KENICHI TANAKA
- Department of Surgery, Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - DAISUKE KURODA
- Department of Surgery, Kita-Harima Medical Center, Ono, Hyogo, Japan
| | - YOSHIHIRO KAKEJI
- Department of Surgery, Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| |
Collapse
|
7
|
Tanakaya K, Furukawa Y, Nakamura Y, Hirata K, Tomita N, Tamura K, Sugano K, Ishioka C, Yoshida T, Ishida H, Watanabe T, Sugihara K, Yamaguchi T, Ishikawa H, Matsubara N, Arai M, Moriya Y. Relationship between smoking and multiple colorectal cancers in patients with Japanese Lynch syndrome: a cross-sectional study conducted by the Japanese Society for Cancer of the Colon and Rectum. Jpn J Clin Oncol 2015; 45:307-10. [PMID: 25583420 DOI: 10.1093/jjco/hyu218] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The positive correlation between smoking and cancer risk is well estimated in sporadic colorectal cancer, whereas little is known with regard to Lynch syndrome-associated colorectal cancer. A total of 118 familial colorectal cancer patients from the Hereditary Nonpolyposis Colorectal Cancer Registry and Genetic Testing Project of the Japanese Society for Cancer of the Colon and Rectum, were assessed to determine whether smoking alters the incidence of multiple colorectal cancers. In male patients with Lynch syndrome (n = 29), the incidence of multiple colorectal cancers in patients who had ever smoked (smoking duration: median of 19 years) was higher than that in those who never smoked (58.8% vs. 10.0%, P = 0.02). The cumulative risk for metachronous colorectal cancer was significantly higher in male Lynch syndrome patients who had previously smoked than in those who had never smoked (P = 0.03). Our data suggest that long-term cigarette smoking might be a strong risk factor for the development of multiple colorectal cancers in male Lynch syndrome patients.
Collapse
Affiliation(s)
| | - Yoichi Furukawa
- Division of Clinical Genome Research, Advanced Clinical Research Center, Institute of Medical Science, The University of Tokyo, Tokyo
| | - Yusuke Nakamura
- Laboratory of Molecular Medicine, Human Genome Center, Institute of Medical Science, The University of Tokyo, Tokyo
| | - Keiji Hirata
- Department of Surgery 1, University of Occupational and Environmental Health, Kitakyushu
| | - Naohiro Tomita
- Department of Surgery, Hyogo Medical University, Nishinomiya
| | - Kazuo Tamura
- Major in Science, Graduate School of Science and Engineering Research, Kinki University, Higashiosaka
| | - Kokichi Sugano
- Oncogene Research Unit/Cancer Prevention Unit, Tochigi Cancer Center, Utsunomiya
| | - Chikashi Ishioka
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Sendai
| | - Teruhiko Yoshida
- Genetics Division, National Cancer Center Research Institute, Tokyo
| | - Hideyuki Ishida
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe
| | | | - Kenichi Sugihara
- Department of Surgical Oncology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | | | | | | | | | | | | |
Collapse
|
8
|
Sakata K, Tamura G, Endoh Y, Ohmura K, Ogata S, Motoyama T. Hypermethylation of the hMLH1 gene promoter in solitary and multiple gastric cancers with microsatellite instability. Br J Cancer 2002; 86:564-7. [PMID: 11870538 PMCID: PMC2375269 DOI: 10.1038/sj.bjc.6600076] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2001] [Accepted: 11/14/2001] [Indexed: 12/17/2022] Open
Abstract
Human cancers with a high frequency microsatellite instability phenotype develop due to defects in DNA mismatch repair genes. Silencing of a DNA mismatch repair gene, hMLH1 gene, by promoter hypermethylation is a frequent cause of the microsatellite instability-H phenotype. Using methylation specific PCR we investigated the methylation status of the hMLH1 gene promoter in 17 solitary gastric cancers (12 microsatellite instability-H and five microsatellite stable tumours from 17 patients), and 13 multiple gastric cancers (eight microsatellite instability-H, one low frequency microsatellite instability-L and four microsatellite stable tumours from five patients) and also examined non-cancerous gastric mucosa both adjacent to and distant from each tumour. Expression of hMLH1 protein was evaluated by immunohistochemistry. All microsatellite instability-H tumours (20 out of 20) had evidence of methylation of hMLH1 promoter, whereas only one out of 10 microsatellite instability-L and microsatellite stable tumours did (P<0.0000005), and the methylation status correlated with hMLH1 protein expression (P<0.000003). Furthermore, methylation of the hMLH1 promoter was detected in 50% (6 out of 12) and 63% (5 out of 8) of non-cancerous gastric mucosa samples adjacent to, and in 33% (4 out of 12) and 40% (2 out of 5) of those obtained from distant portion of, solitary and multiple cancers with microsatellite instability-H. Thus both solitary and multiple gastric cancers with microsatellite instability-H have evidence of similar high levels of hMLH1 promoter hypermethylation in the surrounding non-cancerous tissue. Hypermethylation of the hMLH1 promoter occurs in non-cancerous gastric mucosa of microsatellite instability-H tumours and may increase the risk of subsequent neoplasia.
Collapse
Affiliation(s)
- K Sakata
- Department of Pathology, Yamagata University School of Medicine, Iida-nishi 2-2-2, Yamagata 990-9585, Japan
| | | | | | | | | | | |
Collapse
|
9
|
Ichikawa D, Takahashi T, Hashimoto N, Hoshima M, Kitamura K, Yamane T, Yamaguchi T, Abe T, Inazawa J. Multiple primary cancers with microsatellite instability: report of a case. Jpn J Cancer Res 1996; 87:105-8. [PMID: 8609041 PMCID: PMC5920989 DOI: 10.1111/j.1349-7006.1996.tb00207.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
We report here a patient who developed a variety of tumors both synchronously and metachronously over a 2-year period. The involved organs were the uterus, ureter, and small and large intestines. The patient underwent open surgery 3 times and polypectomies 6 times. Postoperative histopathologic analysis showed 2 adenomas and 8 carcinomas. Genetic analysis revealed microsatellite instabilities at the tested loci in all 10 tumors, indicating that replication errors played an essential role in the tumorigenesis. Early identification of microsatellite instability could be useful for predicting development of additional primary cancers.
Collapse
Affiliation(s)
- D Ichikawa
- Department of Hygiene, Kyoto Prefectural University of Medicine
| | | | | | | | | | | | | | | | | |
Collapse
|