Multiple Primary Malignant Neoplasms in an Elderly Patient

Jai D Parekh,Carrie Valenta,Abhishek Thandra,Shweta Kukrety

doi:10.7759/cureus.2384

Jai D Parekh, Carrie Valenta + Show 2 more

Open Access

https://doi.org/10.7759/cureus.2384

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Journal: Cureus	Publication Date: Mar 28, 2018
Citations: 8	License type: cc-by

Affiliation: Creighton University Medical Center

Abstract

Only a few case reports to date have described patients with three or more cancers. However, the incidence of multiple primary malignancies is increasing due to the improved survival of cancer patients, the prolonged lifespan of the general population, and better diagnostic techniques. This report describes a 73-year-old woman with primary breast, rectal squamous cell, and renal cell carcinomas. This case is unique because, in addition to having three primary malignancies, this patient had rectal squamous cell carcinoma—one of the rarest types of rectal cancer. We discuss screening and prevention of multiple malignancies and rectal squamous cell carcinoma, as well as methods for managing these patients.

Highlights

Multiple primary malignant neoplasms (MPMN) are defined as two or more primary malignancies, in which each tumor is not an extension, recurrence, or metastasis of the other
The occurrence of multiple primary cancers in a single patient is relatively rare, improved survival of cancer patients and a longer lifespan of the general population have increased the incidence of MPMN [1,2]
The patient's rectal squamous cell carcinoma (SCC) was managed with chemoradiation, and the renal tumor was managed with right laparoscopic radical nephrectomy

Summary

Introduction

Multiple primary malignant neoplasms (MPMN) are defined as two or more primary malignancies, in which each tumor is not an extension, recurrence, or metastasis of the other. A 73-year-old Caucasian woman presented with rectal bleeding for one month Her previous medical history included left-sided breast cancer, which was treated with radical mastectomy and adjuvant chemotherapy 18 years earlier. The patient's rectal SCC was managed with chemoradiation, and the renal tumor was managed with right laparoscopic radical nephrectomy. Histopathologic examination of the latter tumor confirmed that it was a clear cell carcinoma, Fuhrman Grade 1-2 (Stage T2a, N0, M0). The patient declined to undergo biopsy of the enlarged nodes and declined to continue receiving dialysis She was discharged home with hospice care and passed away. Diffuse interstitial edema and patchy mononuclear inflammatory cell infiltrates were consistent with acute tubulointerstitial nephritis (Hematoxylin and eosin, 600X)

Discussion

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Disclosures