Abstract
The incidence of multiple primary tumors (MMPNs) ranges from 0.73 to 11.7%. Most often occur double malignancies - 3-5%, much less triples - 0.5%. The aim of the study is to describe the three cases of triple metachronous multiple malignancies, the last of which was a squamous cell carcinoma of lung in all three patients. A retrospective analysis of all medical histories (1163) patients who were hospitalized in the Pulmonary Hospital in Olsztyn, Poland in the period from January 2013 to October 2015, with a diagnosis of at least one neoplasm was performed. We selected only these patients who were diagnosed with histologically confirmed three independent malignancies. The incidence of tumors of triple malignancies was 0.52%. Of all cases of triple malignancies, we selected 3 cases - 2 men and 1 woman, whose last-growing cancer, histopathologically confirmed, was squamous cell lung cancer. Case No. 1 - 54-year-old man with COPD (GOLD 2), who gave up smoking, melanoma of the scalp treated surgically and by chemotherapy (6xDTIC) at the age of 19, Hodgkin NS II at the age of 38 treated with 6xABVD, at the age of 53 years diagnosed with squamous cell carcinoma of the left lung in stage T2N1M0. Due to the low value of spirometry disqualified from surgery, qualified for radiotherapy. Case No. 2 67-year-old man with a history of hypertension, colon cancer at the age of 56, after a laryngectomy because of laryngeal squamous cell carcinoma at the age of 63, diagnosed with asymptomatic squamous cell carcinoma of the right lung in a stage T2N0M0 at the age of 65. Case No. 3 74-year-old woman with atrial fibrillation, stable ischemic heart disease, tongue cancer at the age of 67, and its recurrence in the age of 72, after a right-sided mastectomy and chemotherapy for breast cancer at the age of 69, at the age of 74 diagnosed with squamous cell carcinoma of the left lung. The average age of first cancer was 47, the second 57 years, the third 64 years. 1. Lung cancer often occurs as a subsequent malignancy 2. Another primary malignancy may develop even 30 years later, and therefore the possibility of development the third or another cancer should be considered for all cancer patients. 3. Development of synchronous or metachronous neoplasms should be considered in any case in patients with previous oncological treatment.
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