High incidence combination of multiple primary malignant tumors of the digestive system

BACKGROUND Clinical reports of multiple primary malignant tumors(MPMTs)in the digestive system are increasing.In China,although the survival rate of patients with MPMTs is increasing,the quality of life is very low.Many patients have reached the advanced stage when the second primary tumor is found,resulting in no early intervention and treatment.This is due to the misunderstanding of MPMTs by clinicians,who treat such tumors as metastases.Therefore,before a patient has a second primary tumor,doctors should understand some common combinations of digestive system MPMTs to provide clinical guidance to the patient.AIM To explore the high incidence combination of digestive system MPMTs under heterochronism and synchronization.METHODS A total of 1902 patients with MPMTs at Peking Union Medical College Hospital were analyzed retrospectively.They were divided into metachronous MPMT and synchronous MPMT groups,and then the high incidence combinations of the first primary cancer and the second primary cancer in metachronous cancer and synchronous cancer were sorted.Sex and age differences between metachronous and synchronous tumors were tested by the chi square test and t test,respectively.A P value<0.05 was considered as statistically significant,and SPSS version 26.0(SPSS Inc.,Chicago,Illinois,United States)was used for statistical analysis.RESULTS Among the 1902 patients with MPMTs confirmed by pathology,1811(95.2%)cases were secondary primary cancers,89(4.7%)cases were tertiary primary cancers,and 2(0.1%)cases were quaternary primary cancers.Most(88.2%)of the secondary primary cancers were identified as metachronous multiple primary cancers six months after diagnosis of the first primary cancer.The top ten most common MPMTs in the first primary cancer group ranged from high to low as follows:Breast cancer,thyroid cancer,nonuterine cancer,lung cancer,colon cancer,kidney cancer,uterine cancer,bladder cancer,rectal cancer,and gastric cancer.The highest incidence rate of the first primary cancer in male metachronous cancer was lung cancer(11.6%),the highest incidence rate of the second primary cancer was still lung cancer(24.9%),the highest incidence rate of the first primary cancer in female metachronous cancer was breast cancer(32.7%),and the highest incidence rate of the second primary cancer was lung cancer(20.8%).Among them,breast cancer,nonuterine cancer and uterine cancer were female-specific malignant tumor types,and thyroid cancer also accounted for 79.6%of female patients.The top five metachronous cancer combinations,independent of female-specific malignant tumor types and thyroid cancer,were colon cancer and lung cancer(26 cases),kidney cancer and lung cancer(25 cases),rectal cancer and lung cancer(20 cases),gastric cancer and lung cancer(17 cases),and bladder cancer and lung cancer(17 cases).The most common synchronous cancer combination was colon cancer and rectal cancer(15 cases).CONCLUSION Screening for lung cancer should be performed six months after the detection of colon cancer while rectal cancer screening should be performed within six months.

Clinicopathological significance and prognostic value of claudin10 expression in primary malignant tumors of digestive system:A metaanalysis

Objective:To investigate the correlation between claudin10 expression and clinicopathological characteristics and prognosis of primary malignant tumors of digestive system.Methods:We searched the PubMed,Web of Science,Ovid MEDLINE,CNKI,CQVIP,and WanFang Data databases.The data between claudin10 expression and clinical characteristics as well as survival outcome were extracted.RevMan 5.3 and Stata 15.1 software were employed for metaanalysis.Results:A total of 6 studies containing 512 patients with primary malignant tumors of digestive system were analyzed.The analysis showed that high expression of claudin10 was more common in cancer tissue than in normal tissue[OR=3.22,95%CI(2.26,4.60),P<0.01],and was associated with increasing tumor size[OR=6.21,95%CI(2.44,15.83),P<0.01],high differentiation[OR=0.56,95%CI(0.32,0.99),P=0.05],positive lymph node metastasis[OR=3.41,95%CI(1.09,10.65),P=0.03].The expression of claudin10 was not associated with sex[OR=1.62,95%CI(0.91,2.90),P=0.10],age[OR=1.72,95%CI(0.97,3.07),P=0.06],distant metastasis[OR=4.51,95%CI(0.55,36.70),P=0.16],or prognosis[HR=1.99,95%CI(0.93,4.23),P=0.08].Conclusion:The expression of claudin10 is correlated with the clinicopathological features of primary malignant tumors of digestive system and is a potential tumor marker.

Stability reconstruction after resections of primary malignant tumors

Objective To review the methods of the stability reconstruction after resections of primary malignant spinal tumors.Methods From January 1999 to January 2009,38 cases of primary malignant spinal turmors underwenttumor

Clinical analysis of multiple primary gastrointestinal malignant tumors:A 10-year case review of a single-center

BACKGROUND Multiple primary malignant tumors(MPMTs)was first described by Billroth as early as 1889,with the first report published by Warren and Gates in 1932.Since then,numerous cases have been reported.A literature review of 1104269 patients with cancer revealed that the incidence of MPMTs ranged from 0.73 to 11.7%.In recent years,however,there has been a significant upward trend in the incidence of this phenomenon,which may be associated with many different factors,including the advancement of modern diagnostic procedures facilitating the examination and diagnosis of more MPMTs,increased exposure to chemotherapy and radiotherapy that exacerbate the risk of new malignant tumors in patients with cancer,and prolonged survival of patients with cancer allowing sufficient time for the development of new primary cancers.AIM To analyze the incidence,clinical features,treatment factors,prevalence,and prognosis of patients with MPMTs in the gastrointestinal tract treated in a single center.Additionally,we analyzed the different tumor combinations,time interval between the occurrence of tumors,and staging.METHODS This retrospective cohort study analyzed 8059 patients with pathologically confirmed gastrointestinal malignant tumors treated at the Gansu Province Hospital in Lanzhou,Gansu,China between June 2011 and June 2020.Of these,85 patients had MPMTs.The clinical features,treatment factors,prevalence,and prognosis of this latter cohort were analyzed.RESULTS The incidence of MPMTs in patients with gastrointestinal malignant tumors was 1.05%(85/8059),including 83 double primary malignant tumors and two triple primary malignant tumors of which 57(67.06%)were synchronous MPMTs(SMPMTs)and 28(32.94%)were metachronous MPMTs(MMPMTs).The most frequent associations were found between the rectum colon cancers within the SMPMT category and the gastric-colon cancers within the MMPMT category.For the MMPMTs,the median interval was 53 months.The overall 1-,3-and 5-year survival rates from diagnosis of the first primary cancer were 91.36%,65.41%,and 45.97%,respectively;those from diagnosis of the second primary cancer were 67.90%,29.90%,and 17.37%,respectively.CONCLUSION MPMTs in the gastrointestinal tract have a high incidence and poor prognosis.Thus,it is necessary to perform both gastroscopy and colonoscopy in patients with gastrointestinal tumors.Multidisciplinary comprehensive diagnosis and treatment may improve the diagnosis rate and treatment efficiency of MPMTs.

Primary Malignant Renal Tumors in Infancy and Childhood: CT Appearances

Objective： To investigate the imaging manifestation of primary malignant renal tumor with CT. Methods： Forty-three cases of surgically and pathologically confirmed primary malignant renal tumor were retrospectively reviewed. Un-contrast and contrast CT was performed in all 43 patients in which 15 patients received MRI examination. Results： The residual normal renal tissue of 29 cases out of 34 cases of Wilms＇ tumor was enhanced and manifested ＂crescent sign＂ or ＂ring sign＂. Four cases of malignant rabdoid tumor （RTK） manifested as large mass with notable necrosis and subcapsular fluid collection; Two cases of clear cell sarcoma （CCS） showed metastases to the skull which could indicate the diagnosis; Renal cell carcinoma （RCC） （n=3） showed calcification in 1 case. Conclusion： CT can precisely delineate the location, size, extent of involvement, imaging characteristics and metastases of renal tumor, which can provide information necessary to the clinical staging, therapy planning and prognosis of the tumors.

Heterochronous multiple primary prostate cancer and lymphoma:A case report

BACKGROUND Multiple primary malignant tumors(MPMTs)are rare type of cancer,especially when solid tumors are the first and lymphoma is the second primary malignancy.We report a patient with heterochronous MPMTs consisting of prostate cancer and rectal diffuse large B-cell lymphoma(DLBCL).CASE SUMMARY We report a 77-year-old male patient diagnosed with prostate cancer who was treated with radiation therapy and one year of endocrine therapy with bicalutamide(50 mg per day)and an extended-release implant of goserelin(1/28 d).Seven years later,rectal DLBCL with lung metastases was found.CONCLUSION Although rare,the possibility of prostate cancer combined with a double primary cancer of DLBCL can provide a deeper understanding.

Rare neonatal malignant primary orbital tumors: Three case reports

BACKGROUND Aggressive malignant primary orbital tumors are extremely rare in newborns.The current cases further clarify the clinical features of malignant primary orbital tumors in neonates.CASE SUMMARY At the time of presentation at the Seventh Center of People’s Liberation Army General(PLAG)Hospital,the children were 1-,2-and 5-mo-old,respectively,and included 2 boys and 1 girl.All three cases had unilateral proptosis at birth,and underwent mass excision and histopathologic examination.A peripheral primary neuroectodermal tumor,an aggressive infantile fibromatosis and an embryonic rhabdomyosarcoma were diagnosed,respectively.The first case underwent routine chemotherapy following surgery but died within three months due to worsening condition as the tumor spread throughout the body.The other two children were treated by surgery,and at the follow-up visits 6 mo and 1 year after surgery,respectively,the wound was completed healed,and they had normal growth and development without radiotherapy or chemotherapy.A review of highly uncommon orbital tumors in newborns is also provided.CONCLUSION Malignant primary tumors should be considered in the presence of unilateral proptosis in newborns.

Gastrointestinal stromal tumors and second primary malignancies before and after the introduction of imatinib mesylate

Gastrointestinal stromal tumor （GIST） is the most common mesenchymal malignancy of the gastrointestinal tract.GISTs may coexist with different types of cancer,either synchronous or metachronous （1）.Most GISTs develop in a sporadic fashion,but familial occurrence,such as neurofibromatosis and Carney-triad,has also been reported （2）.The overall frequency of second tumors in different series varied from 4.5% to 33%.The most frequent types of GIST-associated cancers were gastrointestinal carcinomas （47%）,lymphoma/leukemia （7%）,carcinomas of prostate （9%）,breast （7%）,kidney （6%）,lung （5%）,female genital tract （5%）,carcinoid tumors （3%）,soft tissue and bone sarcomas （3%）,malignant melanoma （2%） and seminoma （1%） （1,3-5）.

EFFECTIVENESS OF ELECTROCHEMICAL TREATMENT OF PRIMARY PULMONARY MALIGNANT TUMORS

Electrochemical therapy is a new therapy for the treatment of cancer.From January 1989 to November 1991