Abstract
BackgroundReports of synchronous multiple primary cancers in patients with oral cancer have recently been increasing because of progress in radiographic diagnostic techniques. Multiple primary cancers in patients with oral cavity cancer mainly occur in the head and neck region, lung, and esophagus. 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography is usually used to identify synchronous multiple primary cancers.Case presentationWe herein describe a 69-year-old woman diagnosed with synchronous quadruple multiple primary cancers, namely a squamous cell carcinoma of the mobile tongue, invasive ductal carcinoma of the right breast, intraductal carcinoma of the left breast, and chromophobe renal cell carcinoma of the right kidney. We removed the four tumors over three surgical procedures to reduce the surgical risk because the patient had diabetes mellitus. To the best of our knowledge, this combination of multiple primary cancers has not been reported to date. Importantly, we followed this case for 5 years after surgery. The patient was alive and well with no clinical or radiologic signs of recurrent or metastatic disease at the time of this writing.ConclusionsIn the present case, the kidney cancer could not be detected by 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography but could be detected by contrast-enhanced computed tomography. To avoid overlooking multiple primary cancers of the kidney, we suggest that contrast-enhanced computed tomography should cover a region extending to the inferior margin of the kidney, rather than only to the liver, in patients with oral cavity cancer.
Highlights
Reports of synchronous multiple primary cancers in patients with oral cancer have recently been increasing because of progress in radiographic diagnostic techniques
In the present case, the kidney cancer could not be detected by 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography but could be detected by contrast-enhanced computed tomography
To avoid overlooking multiple primary cancers of the kidney, we suggest that contrast-enhanced computed tomography should cover a region extending to the inferior margin of the kidney, rather than only to the liver, in patients with oral cavity cancer
Summary
The combination of MPCs described has not been reported to date. To avoid overlooking kidney MPC, we suggest that contrast-enhanced CT extends to the inferior margin of the kidney in patients with oral cavity cancer. Early-stage RCC can remain clinically silent for a long time; this kidney cancer in patients with oral cavity cancer may be overlooked. Further reports should be accumulated to make a new protocol for the CT scan range in patients with oral cavity cancer to detect hidden synchronous renal cancer, which may be much more frequently present than previously thought. Consent Written informed consent was obtained from the patient for publication of this case report. Authors’ contributions TM collected the data, images, and clinical information. TM is a doctoral student, TN is an assistant professor, NM is a medical staff member, AM is a research associate, and AA is a professor
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