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Das S, Bramhachari S, Halder A, Tandon A, Lalchandani A. Synchronous Breast Carcinoma, Uterine Myoma, and Ovarian Teratoma in a Single Woman. Cureus 2021; 13:e17977. [PMID: 34540509 PMCID: PMC8440239 DOI: 10.7759/cureus.17977] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2021] [Indexed: 11/16/2022] Open
Abstract
Multiple primary tumors in a patient diagnosed with invasive ductal breast cancer are rarely reported in the literature. Here we present a case of invasive ductal carcinoma of the breast in a 42-year-old lady, with synchronous uterine leiomyoma (UL), ovarian teratoma and with prior history of follicular adenoma of thyroid in the same patient. The clinical presentation and management plan is discussed with a review of the literature. Breast cancer is the most common cancer in women where the concomitant occurrence of multiple primary tumors is a diagnostic and therapeutic challenge. In low- and middle-income countries, where facilities of genetic screening in all patients of synchronous neoplasia are limited due to scarcity of resources, strong clinical suspicion, multidisciplinary management, and follow-up remain important.
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Affiliation(s)
- Saikat Das
- Radiotherapy, All India Institute of Medical Sciences Bhopal, Bhopal, IND
| | - Swagata Bramhachari
- General Surgery, All India Institute of Medical Sciences Bhopal, Bhopal, IND
| | - Ajay Halder
- Obstetrics & Gynaecology, All India Institute of Medical Sciences Bhopal, Bhopal, IND
| | - Ashwani Tandon
- Pathology and Laboratory Medicine, All India Institute of Medical Sciences Bhopal, Bhopal, IND
| | - Ankit Lalchandani
- General Surgery, All India Institute of Medical Sciences Bhopal, Bhopal, IND
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Asaad A, Barron M, Rasheed N, Idaewor P, Saad Abdalla Al-Zawi A. The Rare Diagnosis of Synchronous Breast and Colonic Cancers: A Case Report and Review of Literature. Cureus 2021; 13:e13314. [PMID: 33738159 PMCID: PMC7958932 DOI: 10.7759/cureus.13314] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Any two or more primary malignant tumors, in which each tumor is not an extension, recurrence, or metastasis of the other lesion, are defined or described as multiple primary malignant neoplasms (MPMN). These tumors are increasingly diagnosed despite their rare occurrence rate. The term synchronous tumors is applied if two different tumors originating in the same patient are detected at the same time or within six months; if the second tumor is detected beyond six months, it is called metachronous. Aetiological factors that may predispose patients to MPMNs have been grouped into three broad categories: familial cancer syndromes and other genetic susceptibility factors, common exposures (e.g. tobacco), and carcinogenic effects of cancer treatment. The likelihood of missing asymptomatic synchronous tumors at the time of diagnosis is due to a lack of definitively set guidelines for synchronous tumors. Studying every individual case may aid us in understanding disease biology, developing diagnostic guidelines, and establishing patient-specific management strategies. We present a case report of synchronous breast and colonic cancer in a female patient.
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Affiliation(s)
- Amira Asaad
- Plastic and Reconstructive Surgery, University College of Medical Sciences, London, GBR
| | - Marina Barron
- Emergency Department, South West Acute Hospital, Enniskillen, GBR
| | - Noreen Rasheed
- Breast Radiology, Basildon and Thurrock University Hospital, Basildon, GBR
| | - Philip Idaewor
- Pathology, Basildon and Thurrock University Hospital, Basildon, GBR
| | - Abdalla Saad Abdalla Al-Zawi
- General and Breast Surgery, Basildon and Thurrock University Hospital, Basildon, GBR.,General and Breast Surgery, Anglia Ruskin University, Chelmsford, GBR.,General and Breast Surgery, Mid and North Essex University Hospital Group, Basildon, GBR
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Mehta S, Tan GI, Nahm CB, Chua TC, Pearson A, Gill AJ, Samra JS, Mittal A. Pancreatic resection in patients with synchronous extra-pancreatic malignancy: outcomes and complications. ANZ J Surg 2020; 90:290-294. [PMID: 31943690 DOI: 10.1111/ans.15651] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 12/05/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Patients may present with a resectable pancreatic tumour in the context of a concurrent primary extra-pancreatic malignancy. These patients pose a dilemma regarding their suitability for surgery. We evaluated our experience with such patients who underwent pancreatic resection with curative intent and detailed their outcomes and rationale for surgical decision-making. METHODS A retrospective review of patients with pancreatic concurrent extra-pancreatic primary malignancy who underwent pancreatic resection at our institution over a 12-year period (2005-2016) was performed. Clinical, histopathological and perioperative outcomes were reviewed. RESULTS Ten patients with a median age of 74 years (40-85 years) were identified. Secondary primary tumours included thyroid (n = 2), gastrointestinal (n = 4), small bowel neuroendocrine (n = 1), renal (n = 1) and haematological malignancies (n = 2). Pancreatic tumours included pancreatic ductal adenocarcinomas (n = 6), solid pseudopapillary neoplasms (n = 2) and ampullary carcinomas (n = 2). After a median follow up of 41.3 months (31.3-164 months), 8 of 10 patients were still alive. Two patients died due to metastatic disease from the secondary malignancy (small bowel neuroendocrine tumour and sigmoid colon adenocarcinoma). The post-operative complication rate was 30% with no perioperative 90-day mortality. CONCLUSION Selected patients with a pancreatic and concurrent primary extra-pancreatic malignancy may undergo curative pancreatic resection with favourable outcomes.
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Affiliation(s)
- Shreya Mehta
- Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Grace I Tan
- Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Christopher B Nahm
- Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Terence C Chua
- Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Department of Surgery, Logan Hospital, Metro South Health, Logan City, Queensland, Australia
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Andrew Pearson
- Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Anthony J Gill
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Cancer Diagnosis and Pathology Group, Kolling Institute, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Jaswinder S Samra
- Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Macquarie University Hospital, Macquarie University, Sydney, New South Wales, Australia
| | - Anubhav Mittal
- Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
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Latteri S, Catania VE, Malaguarnera G, Peri A, Bertino G, Frazzetto G, Borzì AM, Biondi A, Perrotta RE, Malaguarnera M. Carcinoembryonic Antigen Serum Levels in Nonmelanoma Skin Cancer. Biomedicines 2018; 6:biomedicines6010024. [PMID: 29473860 PMCID: PMC5874681 DOI: 10.3390/biomedicines6010024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 02/21/2018] [Accepted: 02/21/2018] [Indexed: 02/08/2023] Open
Abstract
Background: Carcinoembryonic antigen (CEA) is a glycoprotein, which is present in the foetal colon, some benign conditions and different malignancies, particularly in colon adenocarcinoma. We focused this study on non-melanoma skin cancer (NMSC). NMSC is a common malignancy and it is an important source of morbidity and death in the world. In this study we evaluated whether CEA level increases in NMSC. Patients and Methods: A total of 566 patients with non-melanoma skin cancer (NMSC) were enrolled; 286 patients with NMSC showed CEA levels above normal values, and 280 showed CEA levels below normal values. Patients with high levels of CEA underwent abdominal ultrasound, gastro endoscopy, colonoscopy, and abdominal CT scans. Results: We studied 566 patients, 286 were positive to CEA and 280 were negative. Of the 286 patients positive to CEA, 132 had basal cell carcinoma (64 patients had an associated cancer) and 154 had squamous cell carcinoma (75 patients were affected by cancer). Of the 280 patients negative to CEA, 130 had basal cell carcinoma (12 were associated with cancer), and 150 had squamous cell carcinoma (18 were associated with cancer). The mean age of the 566 case control subjects were 65–81 years. Of the 10 subjects that were the positive control for CEA, two had cancer. Of the 556 subjects that were the negative control for CEA, three had cancer. Conclusions: In patients that present high serum levels of CEA, we give attention to adenocarcinoma tumour first. The pattern of association may be attributable to bias because the group with NMSC were frequently evaluated than those with no history of NMSC. Our results showed that out of 286 patients that were CEA-positive, 139 had cancer, and of the 280 that were CEA-negative, 30 had cancer. Therefore, 20% of patients do not follow the trend. Other markers should be investigated.
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Affiliation(s)
- Saverio Latteri
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, 95123 Catania, Italy.
| | - Vito Emanuele Catania
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, 95123 Catania, Italy.
| | - Giulia Malaguarnera
- Department of Biomedical and Biotechnological Science, University of Catania, 95123 Catania, Italy.
- Research Centre "The Great Senescence", University of Catania, 95120 Catania, Italy.
| | - Andrea Peri
- Department of General Surgery, Policlinico "San Matteo", University of Pavia, 27100 Pavia, Italy.
| | - Gaetano Bertino
- Hepatology Unit, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
| | - Giuseppe Frazzetto
- Research Centre "The Great Senescence", University of Catania, 95120 Catania, Italy.
| | - Antonio Maria Borzì
- Research Centre "The Great Senescence", University of Catania, 95120 Catania, Italy.
| | - Antonio Biondi
- Department of General Surgery and Medical-Surgery Specialties, University of Catania, 95100 Catania, Italy.
| | - Rosario Emanuele Perrotta
- Department of General Surgery and Medical-Surgery Specialties, University of Catania, 95100 Catania, Italy.
| | - Michele Malaguarnera
- Department of Biomedical and Biotechnological Science, University of Catania, 95123 Catania, Italy.
- Research Centre "The Great Senescence", University of Catania, 95120 Catania, Italy.
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Kocatas A, Dural AC, Sever N, Kankaya B, Dogan M, Yegen G, Gonenc M, Bilgic BM, Bedirhan MA, Alis H. Minimal invasive endoscopic management of synchronous granular cell tumours in the colon and posterior mediastinum. J Minim Access Surg 2014; 10:34-6. [PMID: 24501507 PMCID: PMC3902556 DOI: 10.4103/0972-9941.124469] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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] [Received: 11/29/2012] [Accepted: 05/27/2013] [Indexed: 11/12/2022] Open
Abstract
Granular cell tumour (GCT), which is a rare benign soft tissue neoplasm, is mostly found in the skin and soft tissue but may develop anywhere in the body. There are less than 10 reported cases of mediastinal GCTs in the current literature. Furthermore, colonic GCTs have recently gained attention due to the increased public awareness on the importance of colonoscopy screening. We report a case of a 52-year-old woman diagnosed incidentally with synchronous GCTs of the mediastinum and the hepatic flexure on her routine screening for post-operative follow-up for status-post right modified radical mastectomy due to a T2N1M0, Stage 2B breast cancer.
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Affiliation(s)
- Ali Kocatas
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Cem Dural
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Nurten Sever
- Department of Pathology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Burak Kankaya
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Mahmut Dogan
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Gulcin Yegen
- Department of Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Murat Gonenc
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Bilge M Bilgic
- Department of Pathology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Mehmet Ali Bedirhan
- Department of Chest Surgery, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Istanbul, Turkey
| | - Halil Alis
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
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Bats AS, Roussel H, Narjoz C, Le Frere-Belda MA, Chamming's F, Blons H, Laurent-Puig P, Lecuru F. Microsatellite instability analysis for the screening of synchronous endometrial and ovarian cancer in Lynch syndrome. Anticancer Res 2013; 33:3977-3981. [PMID: 24023337] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
We report on a case of synchronous endometrial and ovarian cancer in a patient with Lynch syndrome. An endometrial biopsy performed during routine screening revealed microsatellite instability (MSI) and loss of expression of human mutL homolog-1 (MLH1) and postmeiotic segregation increased-2 (PMS2) in a setting of complex hyperplasia. Whereas gynaecological screening including clinical examination, pelvic ultrasound, and endometrial biopsy, has not proven its benefit, our case report points out the place of MSI analysis and immunohistochemical investigation of mismatch repair protein expression in endometrial samples during gynaecological screening.
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Affiliation(s)
- Anne-Sophie Bats
- Service de Chirurgie Cancérologique Gynécologique et du Sein, Hôpital Européen Georges-Pompidou, 20-40 rue Leblanc, 75015 Paris, France.
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Aksoy NH, Çevikol C, Ögüş M, Elpek GÖ, Gelen T. Adenocarcinoma arising in villous adenoma of the ampulla of Vater with synchronous malignant gastrointestinal stromal tumour of the duodenum: a case report. J Clin Pathol 2004; 57:1118-9. [PMID: 15452175 PMCID: PMC1770468 DOI: 10.1136/jcp.2004.018143] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- N H Aksoy
- Department of Pathology, Akdeniz University, School of Medicine, 07070 Antalya, Turkey;
| | - C Çevikol
- Department of Radiology, Akdeniz University, School of Medicine
| | - M Ögüş
- Department of Surgery, Akdeniz University, School of Medicine
| | - G Ö Elpek
- Department of Pathology, Akdeniz University
| | - T Gelen
- Department of Pathology, Akdeniz University
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