BACKGROUND Multiple primary malignant neoplasms(MPMNs)are rare,while synchronous MPMNs(SMPMNs)are even less common.Owing to the progression of medical technology and the extension of life expectancy,its incidence is g...BACKGROUND Multiple primary malignant neoplasms(MPMNs)are rare,while synchronous MPMNs(SMPMNs)are even less common.Owing to the progression of medical technology and the extension of life expectancy,its incidence is gradually increasing.CASE SUMMARY Although reports of breast and thyroid dual cancers are common,cases of an additional diagnosis of kidney primary cancer within the same individual are rare.CONCLUSION We present a case of simultaneous MPMN of three endocrine organs,reviewing the relevant literature to enhance our understanding of SMPMNs while emphasizing the increasingly important need for accurate diagnosis and multidisciplinary management whenever this challenging situation arises.展开更多
Multiple primary malignant neoplasms （MPMNs） are rarely reported and it is important to give early diagnosis and proper therapy for these patients. Here reported a case of 62-year-old man with concomitant three earl...Multiple primary malignant neoplasms （MPMNs） are rarely reported and it is important to give early diagnosis and proper therapy for these patients. Here reported a case of 62-year-old man with concomitant three early stage cancer lesions in upper gastrointestinal tract, all of which were detected by endoscopy. The first one was an llc-type lesion at angular part of stomach under endoscopy, which was histologically confirmed to be a mucosal well-differentiated adenocarcinoma.The patient underwent a standard radical gastrectomy for the lesion after the failure of endoscopic treatment. The other two neoplasms were observed during follow-up and were indicated as early stage lesions by synthesizing information from endoscopy, endoscopic ultrasonography, computed tomography and biopsy. One displayed as a hyperemic patch （3cm×4 cm in size） located at the part of esophagus 27 cm away from the incisor teeth and was proved to be moderately differentiated squamous cancer by histopathological examination. The other was an llc-type lesion （3.0 cm×3.5 cm in size） located at the part of esophagus 36 cm away from the incisor teeth, and the biopsy result showed a poorly differentiated squamous carcinoma. Both the two lesions were treated with radical radiation because the patient refused surgery management. No recurrence of former lesions or occurrence of novel lesions were observed during post-treatment follow-up, suggesting radical radiation might be effective for this patient.展开更多
BACKGROUND Two or multiple primary malignant neoplasms(MPMNs)rarely occur in the same patient.It has been reported that MPMNs are easily misdiagnosed as the recurrence or metastasis of malignancies in clinical practic...BACKGROUND Two or multiple primary malignant neoplasms(MPMNs)rarely occur in the same patient.It has been reported that MPMNs are easily misdiagnosed as the recurrence or metastasis of malignancies in clinical practice,affecting the choice of treatment for the patients,thereby resulting in the delay of optimal diagnosis.Next generation sequencing(NGS)can be used to distinguish between multiple primary lung cancers and intrapulmonary metastasis,and may distinguish the origin of tumours in different sites of the body.CASE SUMMARY We report the case of 66-year-old woman who suffered from different malignant neoplasms in the rectum and esophageal and gastrointestinal tract.The first neoplasm rectal adenocarcinoma was diagnosed and removed in 2016.The second and third lesions were diagnosed with esophageal squamous-cell carcinoma(ESCC)and gastrointestinal stromal tumour(GIST),respectively,in 2019.Nextgeneration whole exome sequencing was performed on the tissue specimens of rectal carcinoma,esophageal cancer,GIST,and white blood cells to investigate the relationship between malignancies at different timeframe and determine whether the ESCC and GIST evolved from the rectal adenocarcinoma.Mutations including v-Ki-ras2-Kirsten rat sarcoma viral oncogene homolog,adenomatosis polyposis coli,and mothers against decapentaplegic homolog 4 were detected in rectal adenocarcinoma sample,mast/stem cell growth factor receptor was detected in GIST tissue,and lysine methyltransferase 2D was detected in ESCC specimen.Overall,ESCC and GIST were not genetically evolved from rectal adenocarcinoma,and this patient did not have a trunk driven clone.CONCLUSION NGS is an effective tool to study clonal evolution of tumours and distinguish between MPMNs and intrapulmonary metastasis.展开更多
BACKGROUND Treatment of synchronous multiple primary malignancies is quite often very challenging.Herein,we report on a rare case of synchronous multiple primary malignancies in the esophagus,stomach,and jejunum.CASE ...BACKGROUND Treatment of synchronous multiple primary malignancies is quite often very challenging.Herein,we report on a rare case of synchronous multiple primary malignancies in the esophagus,stomach,and jejunum.CASE SUMMARY A 50-year-old man who was a heavy drinker and smoker with a poor diet,and had a family history of cancer sought treatment due to dysphagia lasting for 4 mo.He was finally diagnosed with lower esophageal squamous cell carcinoma(pT3N2M0,G2,stage IIIB),gastric angular adenocarcinoma(pT3N2M0,G2-G3,stage IIIA)with greater omental lymph node metastasis,and jejunal stromal tumor(high risk).The high-risk jejunal stromal tumor was found during surgery.In spite of radical resection and adjuvant chemotherapy,lymph node metastasis occurred 21 mo later.The patient responded poorly to additional chemotherapy and refused further examination and therapy.He died of widespread metastases 33 mo after surgery.CONCLUSION This case indicates a poor prognosis of synchronous multiple advanced primary malignancies and the importance of comprehensive assessment in the population at high risk for cancer.展开更多
Background: Due to improvements in diagnosis, the better outcomes of oncological patients and the increase in the average age, the incidence of synchronous tumours is likely to increase. Aim: To reflect on the challen...Background: Due to improvements in diagnosis, the better outcomes of oncological patients and the increase in the average age, the incidence of synchronous tumours is likely to increase. Aim: To reflect on the challenges of a case with multiple integrated diagnostic and therapeutic approaches and to bring to consideration the increasing prevalence of similar situations. Case Presentation: In this clinical case, the authors describe the evolution of an asymptomatic patient with several synchronous tumours (a GEJ primary adenocarcinoma, a low grade urothelial carcinoma in situ, a localized squamous cell lung carcinoma and 2 IPMNs). Conclusion: The challenge of this case lies in the difficult diagnostic approach, the assembly of a multidisciplinary and time-sensitive treatment plan and the individualized follow-up, due to lack of guidelines. More research is needed in this area.展开更多
BACKGROUND The diagnosis and etiology of multiple primary malignant neoplasms(MPMNs)are difficult to establish.Here,we report a case of heterochronic triple primary malignancies with gastric cancer,nasopharyngeal squa...BACKGROUND The diagnosis and etiology of multiple primary malignant neoplasms(MPMNs)are difficult to establish.Here,we report a case of heterochronic triple primary malignancies with gastric cancer,nasopharyngeal squamous cell cancer,and then rectal cancer.CASE SUMMARY The patient was first diagnosed with gastric cancer at the age of 33 in 2014 and underwent distal gastrectomy and gastrojejunostomy and six cycles of adjuvant chemotherapy.Three years later,he was diagnosed with nasopharyngeal cancer and treated with radical chemoradiotherapy in 2017.Recently,a mass in the middle of the rectum was resected and reported as ulcerative,moderately to poorly differentiated adenocarcinoma.Research on the etiology of MPMNs showed that Epstein-Barr virus(EBV)infection may be the cause of gastric cancer and nasopharyngeal squamous cell cancer since these two primary lesions were positive for transcripts of EBV-encoded ribonucleic acid using an in situ hybridization EBV-encoded ribonucleic acid probe in formalin-fixed,paraffinembedded tissue.The cause of rectal cancer may be due to a somatic mutation of tumor protein 53 gene in exon 8(c.844C>T,p.Arg282Trp)through highthroughput sequencing for the rectal cancer.Appropriate standard therapy for each primary cancer was administered,and the patient has no evidence of cancer disease to date.CONCLUSION To our knowledge,this is the first report on heterochronic triple primary malignancies whose cause may be associated with EBV infection and tumor protein 53 genetic mutations.The etiological research may not only elucidate the cause of MPMN but also has implications in clinical management.展开更多
Multiple primary cancers refer to the condition where more than two cancers occur independently in an individual. The incidence of lung cancer in cases of colorectal cancer is rare and synchronous rectal cancer and lu...Multiple primary cancers refer to the condition where more than two cancers occur independently in an individual. The incidence of lung cancer in cases of colorectal cancer is rare and synchronous rectal cancer and lung cancer is even rare. A 61-year-old man was referred to our hospital with a 2-month history of blood in his stool, tenesmus, and mucous discharge in July 2010. Colonoscopy showed an irregular ulcerated rectal mass and histological examination of biopsy material showed a poorly differentiated adenocarcinoma. Computed tomography （CT） scan of the chest and abdomen showed a mass in the posterior segment of the right upper lobe of the lung and a mass in the right rectal wall of upper rectum. The rectal tumor was diagnosed as primary cancer based on the findings of immunohistochemical stain. An anterior resection （AR） and video assisted thoracoscopic （VAT） wedge resection were performed and histological findings of resected rectal and lung tumor specimen showed synchronous primary rectal cancer and lung cancer. A combination chemotherapy regimen with docetaxel and Iobaplatin was used and the patient was successfully discharged from hospital in August 2010. Although the incidence of synchronous multiple primary cancers is very low, we need to remain suspicious, when faced with two or even multiple organ lesions, and employ the necessary examination methods to confirm the diagnosis. For synchronous multiple primary cancers, if conditions allow, surgical resection for all the cancers can be performed in a single operation.展开更多
基金Shanxi Soft Science General Program,No.2018041032-2.
文摘BACKGROUND Multiple primary malignant neoplasms(MPMNs)are rare,while synchronous MPMNs(SMPMNs)are even less common.Owing to the progression of medical technology and the extension of life expectancy,its incidence is gradually increasing.CASE SUMMARY Although reports of breast and thyroid dual cancers are common,cases of an additional diagnosis of kidney primary cancer within the same individual are rare.CONCLUSION We present a case of simultaneous MPMN of three endocrine organs,reviewing the relevant literature to enhance our understanding of SMPMNs while emphasizing the increasingly important need for accurate diagnosis and multidisciplinary management whenever this challenging situation arises.
文摘Multiple primary malignant neoplasms （MPMNs） are rarely reported and it is important to give early diagnosis and proper therapy for these patients. Here reported a case of 62-year-old man with concomitant three early stage cancer lesions in upper gastrointestinal tract, all of which were detected by endoscopy. The first one was an llc-type lesion at angular part of stomach under endoscopy, which was histologically confirmed to be a mucosal well-differentiated adenocarcinoma.The patient underwent a standard radical gastrectomy for the lesion after the failure of endoscopic treatment. The other two neoplasms were observed during follow-up and were indicated as early stage lesions by synthesizing information from endoscopy, endoscopic ultrasonography, computed tomography and biopsy. One displayed as a hyperemic patch （3cm×4 cm in size） located at the part of esophagus 27 cm away from the incisor teeth and was proved to be moderately differentiated squamous cancer by histopathological examination. The other was an llc-type lesion （3.0 cm×3.5 cm in size） located at the part of esophagus 36 cm away from the incisor teeth, and the biopsy result showed a poorly differentiated squamous carcinoma. Both the two lesions were treated with radical radiation because the patient refused surgery management. No recurrence of former lesions or occurrence of novel lesions were observed during post-treatment follow-up, suggesting radical radiation might be effective for this patient.
文摘BACKGROUND Two or multiple primary malignant neoplasms(MPMNs)rarely occur in the same patient.It has been reported that MPMNs are easily misdiagnosed as the recurrence or metastasis of malignancies in clinical practice,affecting the choice of treatment for the patients,thereby resulting in the delay of optimal diagnosis.Next generation sequencing(NGS)can be used to distinguish between multiple primary lung cancers and intrapulmonary metastasis,and may distinguish the origin of tumours in different sites of the body.CASE SUMMARY We report the case of 66-year-old woman who suffered from different malignant neoplasms in the rectum and esophageal and gastrointestinal tract.The first neoplasm rectal adenocarcinoma was diagnosed and removed in 2016.The second and third lesions were diagnosed with esophageal squamous-cell carcinoma(ESCC)and gastrointestinal stromal tumour(GIST),respectively,in 2019.Nextgeneration whole exome sequencing was performed on the tissue specimens of rectal carcinoma,esophageal cancer,GIST,and white blood cells to investigate the relationship between malignancies at different timeframe and determine whether the ESCC and GIST evolved from the rectal adenocarcinoma.Mutations including v-Ki-ras2-Kirsten rat sarcoma viral oncogene homolog,adenomatosis polyposis coli,and mothers against decapentaplegic homolog 4 were detected in rectal adenocarcinoma sample,mast/stem cell growth factor receptor was detected in GIST tissue,and lysine methyltransferase 2D was detected in ESCC specimen.Overall,ESCC and GIST were not genetically evolved from rectal adenocarcinoma,and this patient did not have a trunk driven clone.CONCLUSION NGS is an effective tool to study clonal evolution of tumours and distinguish between MPMNs and intrapulmonary metastasis.
文摘BACKGROUND Treatment of synchronous multiple primary malignancies is quite often very challenging.Herein,we report on a rare case of synchronous multiple primary malignancies in the esophagus,stomach,and jejunum.CASE SUMMARY A 50-year-old man who was a heavy drinker and smoker with a poor diet,and had a family history of cancer sought treatment due to dysphagia lasting for 4 mo.He was finally diagnosed with lower esophageal squamous cell carcinoma(pT3N2M0,G2,stage IIIB),gastric angular adenocarcinoma(pT3N2M0,G2-G3,stage IIIA)with greater omental lymph node metastasis,and jejunal stromal tumor(high risk).The high-risk jejunal stromal tumor was found during surgery.In spite of radical resection and adjuvant chemotherapy,lymph node metastasis occurred 21 mo later.The patient responded poorly to additional chemotherapy and refused further examination and therapy.He died of widespread metastases 33 mo after surgery.CONCLUSION This case indicates a poor prognosis of synchronous multiple advanced primary malignancies and the importance of comprehensive assessment in the population at high risk for cancer.
文摘Background: Due to improvements in diagnosis, the better outcomes of oncological patients and the increase in the average age, the incidence of synchronous tumours is likely to increase. Aim: To reflect on the challenges of a case with multiple integrated diagnostic and therapeutic approaches and to bring to consideration the increasing prevalence of similar situations. Case Presentation: In this clinical case, the authors describe the evolution of an asymptomatic patient with several synchronous tumours (a GEJ primary adenocarcinoma, a low grade urothelial carcinoma in situ, a localized squamous cell lung carcinoma and 2 IPMNs). Conclusion: The challenge of this case lies in the difficult diagnostic approach, the assembly of a multidisciplinary and time-sensitive treatment plan and the individualized follow-up, due to lack of guidelines. More research is needed in this area.
文摘BACKGROUND The diagnosis and etiology of multiple primary malignant neoplasms(MPMNs)are difficult to establish.Here,we report a case of heterochronic triple primary malignancies with gastric cancer,nasopharyngeal squamous cell cancer,and then rectal cancer.CASE SUMMARY The patient was first diagnosed with gastric cancer at the age of 33 in 2014 and underwent distal gastrectomy and gastrojejunostomy and six cycles of adjuvant chemotherapy.Three years later,he was diagnosed with nasopharyngeal cancer and treated with radical chemoradiotherapy in 2017.Recently,a mass in the middle of the rectum was resected and reported as ulcerative,moderately to poorly differentiated adenocarcinoma.Research on the etiology of MPMNs showed that Epstein-Barr virus(EBV)infection may be the cause of gastric cancer and nasopharyngeal squamous cell cancer since these two primary lesions were positive for transcripts of EBV-encoded ribonucleic acid using an in situ hybridization EBV-encoded ribonucleic acid probe in formalin-fixed,paraffinembedded tissue.The cause of rectal cancer may be due to a somatic mutation of tumor protein 53 gene in exon 8(c.844C>T,p.Arg282Trp)through highthroughput sequencing for the rectal cancer.Appropriate standard therapy for each primary cancer was administered,and the patient has no evidence of cancer disease to date.CONCLUSION To our knowledge,this is the first report on heterochronic triple primary malignancies whose cause may be associated with EBV infection and tumor protein 53 genetic mutations.The etiological research may not only elucidate the cause of MPMN but also has implications in clinical management.
文摘Multiple primary cancers refer to the condition where more than two cancers occur independently in an individual. The incidence of lung cancer in cases of colorectal cancer is rare and synchronous rectal cancer and lung cancer is even rare. A 61-year-old man was referred to our hospital with a 2-month history of blood in his stool, tenesmus, and mucous discharge in July 2010. Colonoscopy showed an irregular ulcerated rectal mass and histological examination of biopsy material showed a poorly differentiated adenocarcinoma. Computed tomography （CT） scan of the chest and abdomen showed a mass in the posterior segment of the right upper lobe of the lung and a mass in the right rectal wall of upper rectum. The rectal tumor was diagnosed as primary cancer based on the findings of immunohistochemical stain. An anterior resection （AR） and video assisted thoracoscopic （VAT） wedge resection were performed and histological findings of resected rectal and lung tumor specimen showed synchronous primary rectal cancer and lung cancer. A combination chemotherapy regimen with docetaxel and Iobaplatin was used and the patient was successfully discharged from hospital in August 2010. Although the incidence of synchronous multiple primary cancers is very low, we need to remain suspicious, when faced with two or even multiple organ lesions, and employ the necessary examination methods to confirm the diagnosis. For synchronous multiple primary cancers, if conditions allow, surgical resection for all the cancers can be performed in a single operation.
