Synchronous Primary Carcinoma Research Articles

Clinical analysis of 47 cases of synchronous double primary carcinomas of esophagus and cardia

To explore the clinical features and prognosis of the patients with synchronous double primary malignancy of esophagus and cardia. The clinical data of patients with synchronous primary esophageal and cardiac carcinomas undergoing surgery at our hospital between April 1988 and April 2009 were retrospectively reviewed. All data were analyzed by the SPSS 15.0 software. The overall survival rates (OS) were calculated and compared with the Kaplan-Meier method and the Log-rank test. The prognostic factors were identified by Cox's hazard regression model. Among all 47 cases, esophageal carcinoma was missed preoperatively in 1 patients and cardiac carcinoma in 12. The 1-, 3- and 5-year overall survival rates (OS) of the whole group were 81.5%, 49.1% and 34.3% respectively. And the median survival time was 33 months. The univariate analysis of prognostic factors showed that radical resection, N stage of esophageal carcinoma (2009), N stage of cardiac carcinoma (2009) and TNM stage of cardiac carcinoma (both 2002 and 2009) might influence the long-term survival. However, according to the multivariate analysis, only radical resection and N stage of cardiac carcinoma (2009) were independent prognostic factors. With preoperative combined examination of esophagography and esophagoscopy and thorough intraoperative detection, the clinicians may reduce the rate of missed diagnosis for synchronous double primary esophageal and cardiac carcinomas. Radical resection of primary lesions and thorough dissection of locoregional lymph nodes may improve the patient survival.

Clinicopathologic insight of simultaneously detected primary endometrial and ovarian carcinomas

To evaluate the clinicopathologic features in patients with synchronous primary carcinomas of the ovary and endometrium. Clinical information and pathologic details were collected and analyzed from 30 women with synchronous endometrial and ovarian cancers. Median age at diagnosis was 51 years. Abnormal uterine bleeding was the most common presenting symptom (50%). More than half (53%) of the patients were premenopausal and 37% never had a pregnancy. Stage I disease was observed in 90 (27/30) and 73% (22/30) of the patients with endometrial and ovarian cancer, respectively. Endometrioid type was the most frequently observed histology for synchronous endometrial and ovarian cancer (n = 18/30, 60%). All patients were surgically staged and adjuvant treatment was considered when required according to our protocols. The mean follow-up period was 6.6 years (SD = 3.0 years), and the cumulative event-free rate for 5 years was 84.2% (SE 7.3%). No significant differences in the survival rates were found according to the histological subtype (p = 0.513). Women with synchronous primary cancers of the endometrium and ovary were generally younger than those developing either one of the above mentioned adenocarcinomas. They appeared to have a favorable prognosis with an estimated overall survival of 84.2% in 5 years. A gynecologist should always keep in mind the possibility of double primary carcinomas of the endometrium and ovary in a young, premenopausal, nulliparous woman presenting with abnormal uterine bleeding and prompt the patient for further evaluation.

Synchronous primary carcinomas of the rectum and prostate: Report of three cases

Multiple primary tumors(MPT) are a well-known phenomenon. Rapid advancements in diagnostics and therapeutics have contributed to a significant improvement in the survival rates of cancer patients, and also in an increase in the incidence of cases with multiple primary neoplasms, such as synchronous primary carcinomas of the rectum and prostate. We present a case history of a small number of male patients with synchronous primary carcinomas of the rectum and prostate. Two of the threecases were treated with lower anterior resection(LAR) and radical retropublic prostatectomy (RRP) during the same operation, and 1 case was treated with abdominoperineal resection(APR) and RRP during the same operation. No significant complications occurred during these operations. Our experience with these 3cases of synchronous primary carcinomas of the rectum and prostate indicated that LAR or APR and RRP can safely be performed in a single operation.

Triple Synchronous Primary Gynecologic Carcinomas

Double synchronous primaries are known to occasionally occur in gynecologic cancers. Cases of triple or quadruple synchronous primaries, with only 4 case reports in the literature, are extremely rare. The authors report the case of a 49-year-old para 2-0-0-2 woman who presented for surgical management of metastatic ovarian adenocarcinoma diagnosed at an outside institution. On examination of the surgical specimen, 3 synchronous primary carcinomas with multiple histologic features were identified within the ovaries, uterus, and cervix. Although rare, the possibility of triple synchronous primary malignancies should be considered when evaluating gynecologic malignancies.

X-ray diagnosis of synchronous multiple primary carcinoma in the upper gastrointestinal tract

To analyze the radiological features of multiple primary carcinoma (MPC) in the upper gastrointestinal (GI) tract, study its biological characteristics and evaluate X-ray examination in its diagnosis. Hypotonic double-contrast GI radiography was performed in 59 multiple primary carcinoma cases, pathologically proved by surgery or endoscopy biopsy. Radiological findings were analyzed. Of the 59 cases, esophageal MPC (EMPC) was seen in 24, esophageal and gastric MPC (EGMPC) in 27 and gastric MPC (GMPC) in 8. Of the 49 lesions found in 24 EMPC, hyperplastic type was seen in 23, medullary type in 9. The lesions were located at the upper (n = 17), middle (n = 19) or lower (n = 13) segment of the esophagus. In 27 EGMPC, the esophageal lesions were located at the middle (n = 16) or lower (n = 11) segment of the esophagus, while the gastric lesions were located at the gastric cardia (n = 16), fundus (n = 1), body (n = 3) and antrum (n = 7). The esophageal lesions were mainly of the hyperplastic type (n = 12) or medullary type (n = 7), while the gastric lesions were mainly of the hyperplastic type (n = 18). A total of 119 lesions in the 59 patients with synchronous multiple carcinoma were proved by surgery or endoscopy biopsy, and preoperative upper radiographic examination detected 100 of them (84.03% sensitivity). Eighteen (52.94%) of the T(1) lesions were found during preoperative diagnosis by radiographic examination. Moreover, only 3 (3.53%) of the T(2-4) lesions were misdiagnosed. Hypotonic double-contrast upper gastrointestinal examination, providing accurate information about lesion morphology, location and size, can serve as a sensitive technique for the preoperative diagnosis of MPC.

Synchronous primary gall bladder carcinoma and renal transitional cell carcinoma in the same patient: A rare case

Synchronous primary gall bladder carcinoma and renal transitional cell carcinoma in the same patient: A rare case

The synchronous primary carcinomas of the rectum and prostate

The diagnosis of synchronous prostatic and rectal carcinomas is uncommon. To make a correct diagnosis, biopsies of both sites are mandatory. Pathological slides should be compared and immunohistochemical staining should be taken into consideration. In this paper, an unexpected case of synchronous rectal and prostatic carcinomas arising in an 84-year-old male with hematemesis and pelvic pain is reported. These two tumoral components have a distinctive histological appearance. Immunohistochemical evaluation confirmed the diagnosis of these synchronous tumors. This case emphasizes that rectal and prostatic carcinomas can arise simultaneously. In this situation, providing clinicopathological correlation and deciding the necessity of intraoperative consultation in proper time are extremely important.

Development of Marjolin’s ulcer within one month of burn injury with synchronous primary lung squamous cell carcinoma in an elderly patient: report of a case with allelotyping

Marjolin's ulcer defines the occurrence of malignancy, usually squamous cell carcinoma, in the setting of a post-traumatic scar often following thermal injury. The latency period from the time of injury to the onset of malignant transformation averages 30 years with the earliest documented incidence occurring 6 weeks after injury. In addition, the occurrence of multiple primary malignancies is a rare event. To our knowledge, we report the first case in the literature of a well-differentiated squamous cell carcinoma developing within 1 month of thermal injury to an elderly patient's right index finger with an incidental synchronous primary lung moderately differentiated squamous cell carcinoma that was morphologically and genetically different as confirmed by allelotyping. There is scant precedent literature on acute Marjolin's ulcers, and the most acute cases have arisen 6 weeks post-burn. There is also little published literature on the incidence of multiple primary malignancies. The quoted incidence of this event is <1%. Clinicians should be aware of the possibility of malignant transformation at the site of prior thermal injury. Biopsy remains the gold standard for diagnosis for Marjolin's ulcer. MRI is the most important diagnostic imaging tool because it will demonstrate the margins and extent of the lesion. Due to the aggressive nature of Marjolin's ulcer, treatment is usually surgical and dependent upon grading. When multiple lesions are detected after staging of a presumed neoplasm, the possibility of multiple primary maligancies should be considered. Allelotyping is a process that can be utilized to determine if multiple masses are related.

Double synchronous primary renal cell carcinoma with different histotypes

Double synchronous primary renal cell carcinoma with different histotypes

A positive family history of esophageal/gastric cardia cancer with gastric cardia adenocarcinoma is associated with a younger age at onset and more likely with another synchronous esophageal/gastric cardia cancer in a Chinese high-risk area

Background To find a genetic component in gastric cardia adenocarcinomas (GCA). Methods Age at onset (AO) and rate of another synchronous primary upper gastrointestinal carcinoma (RASPUGIC) were compared among the three GCA groups with positive ( N = 766), negative ( N = 2167), and missing family history of upper gastrointestinal cancer (FHUGIC) ( N = 198). These 3131 GCAs were diagnosed on 3128 primary GCA patients of a consecutive surgical cohort treated from 1973 through 1994 at the Department of Thoracic Surgery in the 4th Hospital of Hebei Medical University in a high-risk region in northern China. Results Overall, GCAs of positive FHUGIC showed a significantly younger AO and a significantly higher RASPUGIC than the negative group (54.68 ± 7.35 vs 55.94 ± 7.47 years old, Pt-test = 0.000; 3.1% vs 1.3%, χ2 = 11.02, P = 0.001). The difference in AO and RASPUGIC between the positive and the negative FHUGIC GCAs is significant or nearly significant in most subgroups; minimizing the possibility of a false association due to bias or confounding (e.g. significant stage-specific differences in AO between familial and sporadic GCAs observed in the subgroup of T2,3N0M0 ( P = 0.000) and T2,3,4N1M0 ( P = 0.03) exclude the possibility of ascertainment bias towards an earlier diagnosis in familial cases), and the association between FHUGIC and RASPUGIC is statistically significant for GCAs of younger AO (<55 yr old, RASPUGIC 3.8% vs 1.6% vs 1.1% for the positive, negative and missing FHUGIC GCAs respectively, χ2 = 6.50, P = 0.04), but not significant for the later onset GCAs (≥55 yr old, RASPUGIC 2.5%, 1.1%, 1.9% for the positive, negative and missing FHUGIC respectively, χ2 = 4.22, P = 0.12). Conclusion These findings suggest a genetic component in GCA in the Chinese high-risk region, and genetic predisposition may determine the age at onset and number of primary upper gastrointestinal cancer.

A histopathologic comparison between synchronous and single primary oral squamous cell carcinomas

This study compares synchronous oral squamous cell carcinomas (OSCCs) with single primary OSCCs to assess the histopathologic parameters with a known prognostic significance. Twenty-eight cases of synchronous OSCCs and a control group of single primary OSCCs were compared for 15 histologic prognostic variables. Results showed significantly less amount of abnormal mitoses (synchronous-1: P = .002; synchronous-2: P = .006) and tumor-induced stroma (synchronous-1: P = .011; synchronous-2: P = .001) in synchronous OSCCs than in single primary OSCCs. Depth of invasion was considerably lower in synchronous OSCCs than in single primary OSCCs (synchronous-1: P = .007; synchronous-2: P = .002). Lymph node metastasis (synchronous-1: P = .051; synchronous-2: P = .051) was found to be rare in synchronous OSCCs compared with single primary OSCCs. Synchronous OSCCs show less aggressive histopathologic features than single primary OSCCs.

Synchronous multiple primary gastric carcinomas: A case report

Carcinomas of the stomach are the most common malignant tumors in China. Due to the recent developments in diagnostic techniques and instrumentation, the early detection of gastric carcinoma (GC) has increased. Yet synchronous multiple primary gastric carcinomas, defi ned as 2 or more primary gastric carcinomas occurring in 1 patient simultaneously, are not frequently seen. The etiology of synchronous tumors is still unclear, and their coexistence can be problematic for surgeons, oncologists and pathologists in regards to diagnosis, treatment, and follow-up. Research has focused mainly on such issues as the frequency of occurrence of primary multiple carcinomas, identifi cation of high-risk groups, early diagnosis, treatment methods, and prognostic factors. The purpose of this article is to present a rare case of synchronous tumors and to review the literature addressing the surgical treatment for patients with multiple cancers. In conclusion, we consider that in patients with synchronous multiple primaries, systemic preoperative and postoperative examination for the detection of the associated primary carcinoma is essential and we recommend that it be performed.

Three synchronous primary carcinomas in a patient with HNPCC associated with a novel germline mutation in MLH1: Case report

BackgroundMLH1 is one of six known genes responsible for DNA mismatch repair (MMR), whose inactivation leads to HNPCC. It is important to develop genotype-phenotype correlations for HNPCC, as is being done for other hereditary cancer syndromes, in order to guide surveillance and treatment strategies in the future.Case presentationWe report a 47 year-old male with hereditary nonpolyposis colorectal cancer (HNPCC) associated with a novel germline mutation in MLH1. This patient expressed a rare and severe phenotype characterized by three synchronous primary carcinomas: ascending and splenic flexure colon adenocarcinomas, and ureteral carcinoma. Ureteral neoplasms in HNPCC are most often associated with mutations in MSH2 and rarely with mutations in MLH1. The reported mutation is a two base pair insertion into exon 10 (c.866_867insCA), which results in a premature stop codon.ConclusionOur case demonstrates that HNPCC patients with MLH1 mutations are also at risk for ureteral neoplasms, and therefore urological surveillance is essential. This case adds to the growing list of disease-causing MMR mutations, and contributes to the development of genotype-phenotype correlations essential for assessing individual cancer risk and tailoring of optimal surveillance strategies. Additionally, our case draws attention to limitations of the Amsterdam Criteria and the need to maintain a high index of suspicion when newly diagnosed colorectal cancer meets the Bethesda Criteria. Establishment of the diagnosis is the crucial first step in initiating appropriate surveillance for colorectal cancer and other HNPCC-associated tumors in at-risk individuals.

An Unusual Case of Synchronous Renal Cell Carcinoma in a Horseshoe Kidney and Intrahepatic Cholangiocarcinoma

Abstract: We report an unusual FDG-PET/CT case of synchronous renal cell carcinoma of a horseshoe kidney and intrahepatic cholangiocarcinoma. A 70-year-old man presented with 1 day of frank hematuria, on a background of 4 months’ treatment for polycythemia. CT identified the horseshoe kidney and isthmic tumor, with the renal lesion considered to be the primary neoplasm, and the hepatic lesion considered metastatic. FDG-PET/CT was performed to exclude further metastases. Histopathologic assessment revealed synchronous primary renal cell carcinoma (RCC) of the horseshoe kidney isthmus and intrahepatic cholangiocarcinoma. The polycythemia was attributed to a paraneoplastic effect of the RCC. Helpful factors in identifying synchronous primary tumors in this case were the absence of multiple metastases, and in more typical locations (bone for RCC; lymph nodes for cholangiocarcinoma) and the morphologic feature of minor capsular retraction adjacent to the liver lesion.

Early experience on simultaneous mastectomy and video‐assisted thoracoscopic surgery lobectomy via mastectomy incision

Aim: To assess the feasibility of simultaneous video‐assisted thoracoscopic surgery (VATS) lobectomy and mastectomy via the same incision in patients with synchronous primary carcinoma of the ipsilateral breast and lung.Methods: The patient was first positioned supine and modified radical mastectomy for the breast carcinoma was carried out in the standard way. After that, the mastectomy wound was partially closed and the patient was then turned into a full right decubitus position. Camera and instrument ports were inserted and a utility thoracotomy was made through the mastectomy wound. VATS lobectomy was then carried out.Results: From December 2007 to December 2008, three patients with synchronous primary breast and lung tumour received simultaneous mastectomy and VATS lobectomy through a single mastectomy incision in our institute. There was no operation‐related mortality. The median operation time was 253 min (range 246–345 min) and the median blood loss was 250 mL (range 110–300 mL). All except one patient had uneventful postoperative recovery and deep vein thrombosis was noted in one patient.Conclusion: Simultaneous lobectomy through the mastectomy incision is a safe and feasible treatment option for ipsilateral pulmonary and breast lesion with encouraging outcome.

Synchronous Primary Carcinoma in 5 Different Organs of a Female Genital Tract

The occurrence of double simultaneous primary cancers of the female reproductive tract is a common event. However, the occurrence of synchronous primary quadruple gynecologic malignancies is extremely rare. In this report, the clinical and pathological findings of a 35-year-old female patient with synchronous primary gynecologic cancers regarding papillary serous carcinoma of the left ovary, microinvasive carcinoma in situ of the left and right uterine tubes, endometrial intraepithelial carcinoma of the endometrium, and endocervical carcinoma in situ of the uterine cervix were presented. To our knowledge, the patient presented is the first case in aspect of accompanying ovarian papillary serous carcinoma to bilateral tubal microinvasive carcinoma in situ, endometrial intraepithelial carcinoma, and endocervical carcinoma in situ of the uterine cervix.

Cervical Signet-Ring Cell Carcinoma Presenting as a Synchronous Primary Carcinoma with Uterine Adenocarcinoma

Synchronous primary gynecologic tumors are relatively uncommon with the diagnosis often made following initial surgery. A multiparous female in her 50s with postmenopausal bleeding was referred to our institution with a biopsy-proven diagnosis of endometrial cancer. Preoperative physical exam revealed a suspicious cervical lesion and upon biopsy she was found to have a signet-ring cell carcinoma of the cervix. Secondary to morbid obesity, the patient was not a candidate for a radical hysterectomy and was treated with curative radiation for stage IB 1 cervical carcinoma and clinical stage I endometrial carcinoma. Cervical signet-ring cell carcinoma is an extremely rare pathologic diagnosis. The preoperative discovery of synchronous primary gynecological tumors necessitates individualized planning and treatment.

Clinical analysis of 36 cases with synchronous multiple primary colorectal carcinoma

Objective To explore the diagnosis and surgical treatment of synchronous multiple primary coloreetal carcinoma(SCC).Methods The clinical data of 36 patients with SCC were analyzed retrospectively.Results The 36 patients with SCC were resected simultaneously.Thirty-five patients were reseeted radically and one patient was reseeted palliatively.The 5-,10-year survival rate were 58.3%,41.7%,respectively.There was no significant difference in 5-year and 10-year survival rate between SCC and mono-primary colorectal carcinoma at the same time.Conclusion The preoperative or intraoperative full-course colonoseopy should be emphasized to be a routine method in the patient with colorectal carcinoma.The resection specimen should be examined routinely.Surgical radical resection is the principal in the treatment of SCC. Key words: Cdoreetal neoplasms; Neoplasms,multiple primary

Synchronous primary carcinoma of the cervix and endometrium with early lymph node recurrence

International Journal of Gynecology & ObstetricsVolume 103, Issue 2 p. 181-182 Brief communications Synchronous primary carcinoma of the cervix and endometrium with early lymph node recurrence Virginia Benito, Corresponding Author Virginia Benito virgiben@gmail.com Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Women's and Children's University Hospital, Canary Islands, SpainCorresponding author. Avda. Marítima del Sur s/n, Las Palmas de GC 35011, Canary Islands, Spain. Tel.: +34 928444830; fax: +34 928444827.Search for more papers by this authorLaura Beltrán, Laura Beltrán Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Women's and Children's University Hospital, Canary Islands, SpainSearch for more papers by this authorMiguel Andújar, Miguel Andújar Department of Pathology, Women's and Children's University Hospital, Canary Islands, SpainSearch for more papers by this authorAmina Lubrano, Amina Lubrano Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Women's and Children's University Hospital, Canary Islands, SpainSearch for more papers by this authorOrlando Falcón, Orlando Falcón Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Women's and Children's University Hospital, Canary Islands, SpainSearch for more papers by this author Virginia Benito, Corresponding Author Virginia Benito virgiben@gmail.com Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Women's and Children's University Hospital, Canary Islands, SpainCorresponding author. Avda. Marítima del Sur s/n, Las Palmas de GC 35011, Canary Islands, Spain. Tel.: +34 928444830; fax: +34 928444827.Search for more papers by this authorLaura Beltrán, Laura Beltrán Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Women's and Children's University Hospital, Canary Islands, SpainSearch for more papers by this authorMiguel Andújar, Miguel Andújar Department of Pathology, Women's and Children's University Hospital, Canary Islands, SpainSearch for more papers by this authorAmina Lubrano, Amina Lubrano Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Women's and Children's University Hospital, Canary Islands, SpainSearch for more papers by this authorOrlando Falcón, Orlando Falcón Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Women's and Children's University Hospital, Canary Islands, SpainSearch for more papers by this author First published: 16 July 2008 https://doi.org/10.1016/j.ijgo.2008.05.012Citations: 3Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume103, Issue2November 2008Pages 181-182 RelatedInformation

Coexisting endometrial and ovarian carcinomas: A retrospective clinicopathological study

The purpose of this study was to characterize patients diagnosed with synchronous primary carcinomas of the endometrium and ovary. Between 1985 and 2002, 46 patients with synchronous primary carcinomas of the endometrium and ovary were identified. Clinical and pathological information was obtained from the database and pathological reports. Kaplan–Meier survival analysis, log rank tests of survival differences, and multivariate Cox regression analysis were performed. Median age at diagnosis was 55 years. Twenty-one patients (46%) had an endometrioid histology both of their endometrial and ovarian cancers. Patients with younger age, high uterine differentiation grade, and early-stage ovarian cancer had a more favorable prognosis than those with older age, low grade of differentiation, and advanced stage disease. The Cox proportional hazards model analysis indicates that young age and high grade of differentiation are independent prognostic factors. In this series of patients, women with synchronous primary cancer of the endometrium and ovary were young; the survival rate was greater in patients aged less than 50 years and in patients with an early stage. No significantly different survival between patients with endometrioid carcinoma and patients with non-endometrioid carcinomas was detected.