Multiple Primary Carcinomas Research Articles

Multiple primary carcinomas in one patient – case report

Multiple primary carcinomas in one patient – case report

A Presentation of Multiple Primary Squamous Cell Carcinoma in the Oral Cavity

Multiple primary oral squamous cell carcinomas (SCCs) are uncommon in clinical practice. In this report, we describe 3 synchronous SCCs. A 65-year-old female non-smoker was referred to our facility for evaluation of a SCC on the soft palate. Intraoral examination revealed 2 other erythematous lesions (on the border of the tongue and lower gingiva). Erythroplakia and SCCs were suspected. Incisional biopsies were performed, and the diagnosis was SCC in both lesions. The treatment consisted of anterior marginal mandibulectomy; left partial glossectomy; and hard and soft palate resection with skin free flap reconstruction. In addition, the patient was referred for adjuvant radiotherapy. This case shows a complete diagnosis performed by stomatologists, which led to appropriate treatment.

Treatment of esophageal-gastric double primary cancer by pedunculated remnant gastric interposition, esophageal-gastric anastomosis and gastrojejunal Billroth II anastomosis: A case report.

With the continuous advancement of clinical diagnostic techniques, including imaging technology, the incidence of confirmed multiple primary cancers or double primary carcinoma increases yearly. However, studies reporting synchronization surgery performed for primary dual esophageal gastric cancer are rare. The present study reports the case of a patient with double primary esophageal-gastric cancer, located in the thoracic cavity segment of the esophagus and gastric antrum of the stomach, respectively. The gastric cancer was diagnosed by endoscopy biopsy with concomitant esophageal cancer. The patient underwent gastric cancer resection, and pedunculated remnant gastric interposition esophagogastric side anastomosis was performed with gastrojejunostomy Billroth II anastomosis behind the colon. Abdominal cavity lymph node dissection was also performed. The esophageal-gastric double primary cancer was simultaneously excised and the gastric regions were used in the construction of the upper gastrointestinal tract: The surgery was successful. However, two weeks after surgery, upper gastrointestinal imaging revealed esophagogastric anastomotic leakage. Subsequently, an esophageal stent was inserted and antibiotics and additional treatment was administered. Follow-up one year after surgery revealed that the patient was well and remained in a stable condition.

Multiple simultaneous primary oral squamous cell carcinomas: a previously unreported presentation

The simultaneous occurrence of a second oral squamous cell carcinoma, or in rare cases more, is well known, but to our knowledge, the presentation of 5 primary oral cancers at once has not previously been reported. We discuss this exceptional case and offer a possible explanation for its cause.

非ホジキンリンパ腫の完全寛解後に口蓋粘表皮癌を発症した異時性重複癌の1例

Non-Hodgkin's lymphoma is associated with a potential risk of multiple primary carcinoma. Immune suppression related to this disease or the treatment applied has been suggested to cause multiple primary carcinoma. Therefore, appropriate follow-up and management are essential. We report a case of mucoepidermoid carcinoma of the minor salivary gland of the palate that developed after chemotherapy, total-body irradiation, and allogenic bone marrow transplantation for non-Hodgkin's lymphoma 16 years previously. A-32-year-old woman was referred to our hospital because of a painless mass arising in the right side of the palate, which she had recognized 5 years previously. She had received high-dose chemotherapy, total-body irradiation, and allogenic bone marrow transplantation at 16 years of age for non-Hodgkin's lymphoma. She had remained d isease-free for 16 years. An excisional biopsy was performed with the patient under general anesthesia, and the pathological diagnosis during surgery was low-grade mucoepidermoid carcinoma. The resected region was thus extended. Neither recurrence nor metastasis has occurred as of 22 months after surgery.

Multiple Primary Lung Carcinomas in the Same Lobe

Multiple Primary Lung Carcinomas in the Same Lobe

An Unusual Case of Multiple Primary Carcinomas: Breast Cancer and Rectal Adenocarcinoma in a Single Patient: Report of a Case and Review of the Literature

Introduction: The incidence of multiple primary malignant neoplasms (MPMN) increases with age. While they are nowadays encountered more frequently, the phenomenon is still considered to be rare. Our case represent a rare association between breast and rectal cancer. Multiplicity of primary malignancies itself does not necessarily indicate a poor prognosis as long as adequate diagnosis and management are performed.Case presentation: We report a case of a Moroccan female, aged 46 years old, who was diagnosed with both a breast cancer metachronous and rectal adenocarcinoma within an eleven years period. The literature on multiple primary malignancies in a single patient is reviewed and the data are summarized.Conclusion: From this rare case report and a review of the literature, it would appear that individuals who developed one malignancy might be at greater risk of developing a second. The occurrence of multiple primary malignant neoplasms in our case may be explained by microsatellite instability, and increased surveillance. But there is no genetic predisposition.

Clinicopathological Characteristics in Oesophageal Squamous Cell Carcinoma

Oesophageal cancer is an aggressive disease with a generally poor prognosis. Frequently, patients present late with obstructive symptoms indicating advanced tumours. Therefore, serial histopathological investigations of oesophageal cancer are now being performed more extensively, and several distinctive clinicopathological features have been demonstrated. In this review, we present some of the distinctive features of oesophageal cancer and discuss their clinicopathological significance. These characteristics include: (1) the frequent presence of lymph node metastasis, (2) the morphological features and depth of tumour invasion, (3) the synchronous and metachronous occurrence of carcinoma of other organs, (4) the frequent coexistence of squamous epithelial dysplasia, (5) the frequent coexistence of intraepithelial spread, blood vessel, and lymphatic permeation, (6) the occasional existence of intramural metastasis, (7) the frequent coexistence of multiple primary carcinomas and (8) the occasional coexistence of glandular differentiation with squamous cell carcinoma (SCC).

Clinical characteristics of multiple primary carcinomas of the oral cavity

This study aimed to clarify the clinical characteristics of multiple primary carcinomas of the oral cavity. We retrospectively reviewed the cases of 1015 patients who were treated during follow up for oral cancer at Tokyo Medical and Dental University between March 2001 and December 2012. We compared the clinical characteristics of 961 patients who developed single primary oral squamous cell carcinoma (SCC) during follow up and 54 patients who subsequently developed multiple primary carcinomas in the oral cavity. Mean age at first diagnosis was significantly higher in patients with multiple primary carcinomas than single primary carcinoma. Multiple primary carcinomas showed a female predilection, were most prevalent in the gingiva, and tended to show earlier tumor and nodal stages than single primary carcinoma. The local recurrence rate was higher for multiple primary carcinomas than single primary carcinoma, and it increased with the number of multiple primary occurrences. The disease-specific survival rate at 10 years for patients with single primary carcinoma was 85.3% and that for patients with multiple primary carcinomas was 79.6%. The cumulative incidence rate for metachronous second multiple primary carcinomas after the onset of first carcinoma at 10 years was 8.0%. The recurrence of multiple primary carcinomas did not decrease the survival rate. Differences were found in the clinical characteristics between patients with single oral SCC and those with multiple primary oral carcinomas. Early diagnosis and treatment as well as close long-term follow up are needed for patients with multiple primary oral carcinomas.

Epithelial-mesenchymal transition (EMT) markers have prognostic impact in multiple primary oral squamous cell carcinoma.

Multiple primary tumors can occur in up to 35 % of the patients with head and neck cancer, however its clinicopathological features remain controversial. Deregulation of epithelial-mesenchymal transition (EMT) signaling has been associated with aggressive malignancies and tumor progression to metastasis in several cancer types. This study is the first to explore EMT process in multiple primary oral squamous cell carcinomas (OSCC). Immunohistochemical analysis of E-cadherin, catenin (α, β, and γ), APC, collagen IV, Ki-67, cyclin D1, and CD44 were performed in a tissue microarray containing multiple representative areas from 102 OSCC patients followed-up by at least 10 years. Results were analysed in relation to clinicopathological characteristics and survival rates in patients presenting multiple primary tumors versus patients without second primary tumors or metastatic disease. Significant association was observed among multiple OSCCs and protein expression of E-cadherin (P = 0.002), β-catenin (P = 0.047), APC (P = 0.017), and cyclin D1 (P = 0.001) as well as between lymph nodes metastasis and Ki-67 staining (P = 0.021). OSCCs presenting vascular embolization were associated with negative β-catenin membrane expression (P = 0.050). There was a significantly lower survival probability for patients with multiple OSCC (log-rank test, P < 0.0001), for tumors showing negative protein expression for E-cadherin (log-rank test, P = 0.003) and β-catenin (log-rank test, P = 0.031). Stratified multivariate survival analysis revealed a prognostic interdependence of E-cadherin and β-catenin co-downexpression in predicting the worst overall survival (log-rank test, P = 0.007). EMT markers have a predicted value for invasiveness related to multiple primary tumors in OSCC and co-downregulation of E-cadherin and β-catenin has a significant prognostic impact in these cases.

Surgical resection versus radiofrequency ablation for primary hepatocellular carcinoma of 3-5 cm in diameter: a meta-analysis

To compare the therapeutic effects of surgical hepatic resection (HR) and radiofrequency ablation (RFA) in treatment of primary hepatocellular carcinoma of 3-5 cm in diameter. The databases PubMed, CBMdisc, CNKI, WanFang Data and VIP databases were searched for controlled clinical trials on evaluating the efficacy between RFA and HR in treatment of primary hepatocellular carcinoma of 3-5 cm in diameter published from January 1990 to February 2014. Two reviewers independently screened the literature, extracted the data and assessed the methodological quality of the studies included. Then the meta-analysis was performed by using RevMan5.0 software. Eleven controlled clinical trials were included, including one randomized controlled trial and 10 non-randomized controlled trials. A total of 811 patients were involved: 404 patients were treated with RFA as the initial treatment and 407 patients with surgical resection. Meta-analysis showed that for a single lesion with diameter of 3-5 cm of primary hepatocellular carcinoma, the 3-， 5-year disease-free survival rates in HR group was significantly higher than those in RFA group (all P<0.05). There were no significant difference in the 1-， 3-， 5-year overall survival rates and 1-year disease-free survival rate between RFA group and HR group (P>0.05). For 1-2 nodules with diameters of 3-5 cm of primary hepatocellular carcinoma, the 3-， 5-year disease-free survival rates and 5-year overall survival rates in HR group was significantly higher than those in RFA group (all P<0.05). No significant difference in 1-， 3-year overall survival rates and 1-year disease-free survival rate was found between RFA group and HR group (P>0.05). For maximum nodule of 3-5 cm of multiple primary hepatocellular carcinoma, the 5-year overall survival rates in HR group was significantly higher than that in RFA group (all P<0.05). No significant difference in 1-， 5-year overall survival rates was noted between RFA group and HR group (P>0.05). For primary hepatocellular carcinoma of 3-5 cm in diameter, HR is better than RFA. For the limitation of quality and quantity of included studies, this conclusion needs to be confirmed by more high quality studies.

Stereotactic Body Radiation Therapy for the Treatment of Multiple Primary Non-Small Cell Lung Carcinoma

Stereotactic Body Radiation Therapy for the Treatment of Multiple Primary Non-Small Cell Lung Carcinoma

Solitomab, an EpCAM/CD3 bispecific antibody (BiTE®), is highly active against primary chemotherapy-resistant ovarian cancer cell lines in vitro and fresh tumor cells ex vivo

Objectives: Chemotherapy-resistant ovarian cancer remains an incurable disease. Solitomab is a novel bispecific single-chain antibody that targets the epithelial antigen EpCAM on tumor cells and also contains a CD3-binding region. We evaluated the in vitro activity of solitomab against multiple primary chemotherapy-resistant epithelial ovarian carcinoma cell lines and malignant tumor cells in ascitic fluid.

Multiple Primary Squamous Cell Carcinomas of the Oral Cavity

There is a subset of patients who develop multiple primary squamous cell carcinomas (SCCs) of the oral cavity. The aim of this study was to better characterize this group of patients and determine whether there are any associated risk factors. This is a retrospective review of all patients treated for oral SCCs at the University of Maryland Department of Oral and Maxillofacial Surgery from November 1989 to February 2013. The inclusion criteria were patients who developed at least 3 primary oral cancers. Lesions were considered separate primaries if they involved different anatomic regions within the oral cavity and were more than 2 cm apart or if they occurred more than 5 years apart. Of 1,478 patients treated during this time frame, 20 met the inclusion criteria. There were 14 women and 6 men (female-to-male ratio, 2.3:1). Nineteen were Caucasian and 1 was of Indian ethnicity. The average number of primaries per patient was 3.9 (range, 3 to 6 primaries). The mean age at first diagnosis was 63.3 years (44 to 86 yr). The mean interval between the different primaries was 32 months (0 to 228 months). The most common site involved was the gingiva (45% of cases), followed by the tongue, buccal mucosa, retromolar fossa, and soft or hard palate. The mean follow-up was 118 months (22 to 342 months). Eleven patients developed nodal disease. Of those 11 patients, 9 died of the disease (<20% survival). The average time to neck involvement was 66.4 months. The average time from last neck involvement to death was 11.5 months. More than half the patients were nonsmokers or had quit more than 10 years before the first diagnosis. All patients quit smoking during the course of their treatment yet continued to develop multiple primaries. Three patients had proliferative verrucous leukoplakia (PVL), and 4 patients had biopsy-proved lichen planus. The incidence of multiple primary SCCs within the oral cavity appears to more commonly involve Caucasian women without risk factors, although lichen planus and PVL might play a role. The gingiva appears to be the most commonly involved primary site, and subsequent primaries tend to be restricted to the oral cavity. Close observation and early expectant treatment appear to improve prognosis and survival in these patients. Cervical nodal metastases adversely affected survival (P = .02) as did the development of more than 4 primary carcinomas (P = .04).

A Case of Carcinoma of the Mandibular Gingiva Complicated by Malignant Lymphoma

The incidence of malignant lymphoma has recently increased and it is becoming more common to encounter multiple primary carcinomas including the present case. In a case with multiple primary carcinomas with malignant lymphoma, it is necessary to determine the priority and treatment plan according to the clinical stage and the prognosis of the diseases. We therefore report a case with multiple primary carcinomas of the mandibular gingiva complicated by malignant lymphoma. Patient: 75-year-old male. Chief complaint: fecal occult blood. The patient visited the department of gastrointestinal medicine due to fecal occult blood in December 2006. A biopsy was conducted because the endoscopy revealed adenomatoid lesion. Consequently, the patient was diagnosed with diffuse large B-cell lymphoma and was transferred to the department of hematology to receive R-COP therapy. After two courses of the chemotherapy, an ulcerative lesion was detected on the buccal gingiva of the lower left molars in February 2007, which was diagnosed as squamous cell carcinoma of the mandibular gingiva (T2 N0 M0) by pathological examination, CT and MRI. Subsequently, marginal resection of the mandible was performed. Three months after the operation, four courses of R-COP therapy were conducted.

Characteristics and prognostic factors of synchronous multiple primary esophageal carcinoma: A report of 52 cases.

To retrospectively analyze the clinical characteristics and prognostic factors of 52 cases of synchronous multiple primary esophageal carcinoma (SMPEC), in order to provide a reference for treatment strategy. Clinical and survival data of 52 patients with SMPEC were analyzed retrospectively. The rates of overall survival (OS), depending on the different factors, were calculated using Kaplan-Meier analysis. A log-rank test was used for univariate survival analysis and Cox's proportional hazards regression model was used for multivariate survival analysis. Clinical and survival data of 52 patients with SMPEC, hospitalized from 1 January 2003 to 31 October 2011, were analyzed. Twelve patients underwent surgical resection, five received adjuvant radiotherapy and one received adjuvant radiochemotherapy. Thirty-seven of the 40 non-operative patients received external beam radiation therapy and 20 of them received platinum-based chemotherapy. Another three non-operative patients were given platinum-based chemotherapy alone. The one, three, and five-year OS and the median survival time (MST) were 65.4%, 17.3%, 7.7%, respectively, and 15.0 months for the whole cohort. Tumor length and M stage were independent prognostic factors for the whole cohort by multivariate survival analysis (P = 0.010 and 0.047, respectively). For the radiotherapy subgroup, multivariate analysis of prognostic factors identified that shorter tumor length, M0 stage, and chemotherapy were the predominant independent predictors of long-term survival (P = 0.039, 0.022 and 0.010, respectively). SMPEC is a relatively rare and aggressive tumor. Combined radiotherapy with chemotherapy seemed to bring a survival benefit and may be a better management choice for unresectable and non-operative SMPEC.

Rectal cancer metastasizing to cervical and ovarian combined with multiple primary breast carcinoma: a case report

Rectal cancer metastasizing to cervical and ovarian combined with multiple primary breast carcinoma: a case report

Multiple primary carcinomas including esophageal basaloid squamous cell carcinoma and gastric adenocarcinoma

Synchronous multiple primary carcinomas refers to 2 or more than 2 kinds of different primary malignant tumors develop synchronously or in 6 months.The incidence of synchronous multiple primary carcinoma is low.A patient with esophageal basaloid squamous cell carcinoma (BSCC) and gastric adenocarcinoma was admitted to the First People's Hospital of Lianyungang in October 2011.The main symptom of this patient was dysphagia,and multiple lesions were found in esophagus,cardia and stomach fundus by gastroscopy respectively.On computed tomography image,eminence lesion in esophageal midpiece and wall thickening from esophagus-cardia to stomach fundus were displayed and were both enhanced slightly by enhancement scanning.The esophageal and cardia tumors were resected via left thoracic approach,and postoperative pathological examination revealed esophageal BSCC and moderately differentiated adenocarcinoma of cardia respectively.Comedo necrosis and red basal membrane material were seen under light microscope.The expressions of cytokeratin 5/6 and P63 were positive,the expression of cytokeratin L was weak positive and the expressions of synaptophysin,chromogranin A and CD117 were negative.The patient suffered from pleural effusion and multiple liver metastases after 4 months follow-up and died of liver metastases in May 2012.Multiple primary carcinomas including esophageal BSCC and gastric adenocarcinoma are rarely seen in clinical practice.Their diagnosis and differential diagnosis mainly depend on histological morphology and immunohistochemical method.Surgical resection combined with postoperative radiotherapy and chemotherapy is selectable,but the prognosis is poor. Key words: Esophageal neoplasms; Gastric neoplasms; Multiple primary carcinomas

Retreatment of a patient who presented with synchronous multiple primary colorectal carcinoma: report of a case.

It is well known that one-stage resection of synchronous multiple primary colorectal carcinoma is an ideal choice if the patient's physical condition is not bad. Detailed examination of the whole intestinal tract is very important for patients with colorectal cancer, which could prevent patients from receiving repeat treatment to a great extent. We present a case report of a patient with synchronous primary colorectal cancer. Because pre- or intra-operative examination is not sufficient at his first consultation, the patient had undergone multiple operations after receiving chemotherapy, radiotherapy and intestinal stent insertion, which results in peritoneal adhesions formation. The preoperative placement of prophylactic ureteral catheters facilitated recognition of ureters in operation that assure the prevention of ureteral injuries. If not aware of the importance of detailed preoperative examination and standardized treatment can lead to wrong treatment as in this case. Prophylactic ureteral catheters might assist in their immediate recognition.

Laparoscopic colectomy for synchronous multiple primary colorectal carcinoma

Synchronous multiple primary colorectal carcinoma (SCC) is rarely seen in the clinical practice,while it has a increasing tendency of incidence.The surgical treatment of SCC has not been normalized.The extent of resection should be individually determined according to the lesion location,range,the distance of lesions and the general condition of the patients.Total mesorectal excision (TME) and complete mesocolic excision (CME) were recognized as the standardized surgical treatment for SCC.From August 2010 to May 2013,3 patients with SCC received laparoscopic radical resection for SCC at the Huizhou First People's Hospital.Based on the clinical practice,we concluded that having a tacit teamwork,grasping the precise surgical plane,using skilled technology of dissecting blood vessel and excising the total mesentery of colorectum are guarantees for successful operation.Laparoscopic colectomy for SCC is feasible and safe. Key words: Colorectal neoplasms, synchronous ; Multiple neoplasms ; Laparoscopy