Synchronous Primary Malignancies Research Articles

Uncommon Metachronicity: Breast and Endometrial Carcinomas in a Young Woman with No Familial Cancer History - A Case Report

Background: Worldwide, breast and endometrial carcinomas are the two most common cancers of women, but their coexistence in a woman <40 years of age is a rare event. The risk of developing a new second primary cancer is higher in cancer survivors compared to those without a history of cancer. The exact pathogenesis of two different primary malignancies is not clear. Still, the coexistence of breast and endometrial carcinoma may be due to germline mutations of p53, BRCA 1, and BRCA 2 genes, environmental, hereditary, and immune-mediated factors. Case Presentation: The present case report briefs the finding of a 37-year-old woman who presented to the Gynecological outpatient department with complaints of abnormal uterine bleeding and a solid irregular lump in the upper outer quadrant of the right breast and the right axilla. She had a history of modified radical mastectomy for left breast ductal carcinoma five years back. She was diagnosed as a case of metachronous endometrial carcinoma (stage IA) with a recurrence of invasive ductal carcinoma in the right breast with metastasis to the right axillary lymph node. Conclusion: The metachronous development of breast and endometrial carcinoma in young women is relatively rare. In young patients <40 years of age with gynecological or breast carcinoma, a thorough work-up, including genetic testing and follow-up, should be done for early diagnosis of metachronous or synchronous primary malignancies of other organs.

Clinico-Morphological Features and Immunohistochemical Profile of a Rare Case of Three Synchronous Primary Malignancies in the Female Genital Tract

(1) Background: Synchronous tumors are defined as tumors that occur at the same time, appearing within 2 months, according to the Surveillance Epidemiology and End Results Program, with a frequency of tertiary tumors of 0.5%. The purpose of this presentation is to report a case of three synchronous tumors of the female genital tract, given the fact that it represents a challenge both therapeutically and in demonstrating that the malignant lesions are completely different from each other. (2) Methods: We report the case of a 45 year-old patient diagnosed with three synchronous tumors developed in the genital tract: clear-cell ovarian carcinoma, uterine endometrioid adenocarcinoma, and cervical adenosquamous carcinoma. (3) Results: Total hysterectomy with bilateral anexectomy was performed and accompanied by a biopsy of the greater omentum. The evolution of the patient was favorable during chemotherapy, but she died two weeks after the completion of this treatment, from a cause secondary to the adverse effects determined by it, namely, severe thrombopenia which caused a massive lower digestive hemorrhage. (4) Conclusions: This case demonstrates the maximum importance of the involvement of adjuvant diagnostic techniques, especially when it comes to a diagnostic challenge with direct implications in the subsequent therapy of the patient.

Characterizations of uveal melanoma patients with three additional primary malignancies.

In a population-based cohort of 960 uveal melanoma (UM) patients, we describe patients with three additional malignancies, including one unique patient with four synchronous primary malignancies. A descriptive presentation of the clinical course and outcome for UM patients with three additional primary malignancies. After more than 20 years of follow-up of the UM cohort, 11 patients (1.1%) were diagnosed with three additional primary malignancies before, simultaneously or after UM. Among these, one patient had four synchronous primary malignancies, detected during workup for a symptomatic UM. All diagnoses were treated during the following 4 months, firstly the breast cancer, thereafter, the lung and pancreatic cancers and finally the UM. The patient died 3 years later of abdominal carcinomatosis due to the pancreatic cancer. The family history and gene testing did not disclose any genetic predisposition for cancer. A comparison of the four synchronous tumours, morphologically and immunohistochemically, showed no similarities and the expression of antibodies was different. Patients with UM may be diagnosed with non-ocular additional primary cancers. Thus, a comprehensive workup is obligatory and a further follow-up of the UM patients seems necessary. The UM is not always the main problem.

S2706 An Interesting Case of Synchronous Primary Malignancies in the Gastrointestinal Tract

S2706 An Interesting Case of Synchronous Primary Malignancies in the Gastrointestinal Tract

The impact of the COVID-19 pandemic on nasopharyngeal carcinoma patients – a national cancer centre experience

Purpose or objectiveThe COVID-19 pandemic has resulted in significant healthcare implications, with care for cancer patients compromised due to resource diversion towards battling the pandemic. We aim to investigate the impact of the peak wave of the pandemic in 2020 on the delivery of cancer care in Singapore, specifically via our nasopharyngeal carcinoma (NPC) treatment data. This study applies real world numbers to the impact of COVID-19 on cancer care delivery in Singapore. The choice of nasopharyngeal cancer allows a good direct estimate of common treatment measures such as time to biopsy, time to staging scans, time to treatment commencement, due to its clear protocol and algorithms for staging and treatment; thus serving as an excellent surrogate for the effectiveness and timeliness of the different aspects of cancer care delivery.Materials and methodsIn this retrospective study, we included all patients with newly diagnosed NPC from 1st January to 31st May from 2017 to 2020 at our centre. This time period was chosen as it coincided with the period in 2020 during the COVID-19 pandemic where there was the most strain on healthcare resources and the most restrictions on population movement within Singapore, which may impact on healthcare seeking behaviour. Narrowing down the time period to the first 5 months of the 4 respective years also allowed us to reduce the effect of annual seasonal variation in patient numbers seen as a result of holidays and festive periods such as the Lunar New Year and scheduled school holidays. Electronic medical records (EMR) were accessed. Only newly diagnosed NPC cases were included in our analysis. Patients with second synchronous primary malignancies or NPC disease recurrence were excluded. Data analysis was carried out using a combination of SPSS and Microsoft Excel.ResultsSignificantly, there was a reduction of 37–46.3% in newly diagnosed NPC cases during the peak of the COVID-19 pandemic from January to end May 2020 compared to the preceding three years. Despite the reduction in numbers of newly diagnosed NPC, there was no statistically significant differences in delay from biopsy to the first radiation oncology visit and from biopsy to the first day of treatment in 2020 compared to the preceding years. All the patients treated in our centre also received the standard NPC treatment for their disease stage as per international guidelines.ConclusionWe recommend a heightened awareness of the dangers of delaying cancer presentation and care in healthcare policies and resource allocation and at the same time, encourage patient’s confidence in their ability to seek care. With the resurgence of new COVID-19 variants and case numbers worldwide and in Singapore, this study focuses upon the need to be aware of the exigencies of other clinical groups in resource utilization. It would be instructive to compare this study with future long term follow up to investigate the trajectory of our cancer care delivery, as well as survival outcomes.

Case report: multiple lesions during navigation bronchoscopy; seen one, seen them all?

Peripheral pulmonary nodules are often detected as multiple nodules in one patient. Computed tomography (CT) guided transthoracic biopsy (TTNB) is the most widely implemented method for minimal invasive biopsy of pulmonary nodules, but generally only one nodule is sampled per procedure. Navigation bronchoscopy is an endobronchial procedure with very low complication rates, and uses high-end image guidance which allows for the sampling of multiple nodules in one session, while also allowing inspection of the central airways and endobronchial ultrasound (EBUS) guided staging in one session. This report presents a unique case with three different synchronous primary tumors treated with three different treatment modalities that highlights the added value of cone-beam CT guided navigation bronchoscopy (CBCT-NB) in the diagnostic work-up of suspected early-stage lung cancer. This case describes an asymptomatic patient with no history of prior lung cancer referred because of a shadow seen on a screening X-ray. CT and positron emission tomography (PET) showed two nodules for which a navigation procedure was performed. Both nodules were sampled, and on inspection, a third occult endobronchial lesion was also found. Pathology revealed three separate primary tumors, which were treated with three different treatment modalities: surgery, radiotherapy and endobronchial cryoablation. Current follow-up at 12 months shows no signs of recurrence. This case highlights that synchronous primary malignancies do occur and require a patient tailored approach to minimize treatment related morbidity and optimize survival. To this goal, image guided navigation bronchoscopy allows for a full and complete diagnostic evaluation and can be combined with a staging EBUS in one single session.

Synchronous Second Primary Cancers of Hypopharyngeal Carcinoma in the Image-Enhanced Endoscopy Era.

To explore the prevalence of hypopharyngeal carcinoma (HPC) with synchronous second primary malignancies (Syn-SPMs), their impact on clinical outcomes, and associated risk factors in the image-enhanced endoscopy era. We retrospectively analyzed 673 patients newly diagnosed with HPC at our cancer center between 2009 and 2019. The patients were divided into three groups: (a) no second primary malignancies (N-SPMs, n= 533); (b) synchronous carcinoma in situ (Syn-Tis, n= 60); (c) synchronous invasive tumors (Syn-invasive, n= 80). Propensity score matching was conducted to balance the N-SPMs and Syn-invasive groups at a 3:1 ratio. Most (96.1%) underwent pretreatment esophagogastroduodenoscopy evaluation with image-enhanced endoscopy. The incidence rates were: Syn-SPMs, 20.8%; Syn-Tis, 8.9%; Syn-invasive, 11.9%. At a median follow-up of 66.7 months, the Syn-Tis and N-SPMs groups had a similar 5-year overall survival (OS; 45.6% vs. 44.5%; hazard ratio [HR], 0.956; 95% confidence interval [CI], 0.660-1.385; p=0.806). Compared to the N-SPMs group, the Syn-invasive group had poorer 5-year OS (27.0% vs. 52.9%; HR, 2.059; 95% CI, 1.494-2.839; p < 0.001). Alcohol consumption was significantly associated with Syn-SPMs occurrence (odds ratio, 2.055, 2.414, and 3.807 for light, intermediate, and heavy drinkers, respectively). The prevalence of Syn-SPMs among patients with HPC was high. Syn-invasive SPMs decreased the survival of patients with HPC. Routine screening with image-enhanced endoscopy should be recommended to detect early-stage SPMs, especially for heavy alcohol drinkers. 3 Laryngoscope, 133:1906-1913, 2023.

Treatment Outcomes for Radiation Therapy with Concurrent Carboplatin and Paclitaxel for Locally Advanced Head and Neck Cancer

<h3>Purpose/Objective(s)</h3> There is a lack of consensus on what is the preferred systemic regimen in combination with radiation therapy for cisplatin-ineligible patients with locally advanced head and neck squamous cell carcinoma (HNSCC). We report the outcomes of cisplatin-ineligible patients with HNSCC treated with definitive radiation therapy and weekly concurrent carboplatin and paclitaxel at our institution. <h3>Materials/Methods</h3> We included consecutive HNSCC patients treated from 2013 to 2021 that received definitive radiation therapy with weekly carboplatin and paclitaxel for oropharynx, larynx, hypopharynx and unknown primary cancers. We excluded patients who received induction chemotherapy or re-irradiation and patients who had multiple or synchronous primary malignancies. Locoregional control (LRC) and distant control (DC) were estimated using cumulative incidence functions while progression free survival (PFS) and overall survival (OS) were estimated using Kaplan-Meier methods. <h3>Results</h3> Sixty-six patients were identified with median age of 70 years (range 44 – 85). Disease sites included oropharynx (n=44), larynx (n=15), hypopharynx (n=5), and unknown primary cancer (n=2). Thirty-five patients (53%) had HPV+ disease. Thirty-three patients had T3 or 4 disease (50%) and 48 (72.7%) had N2 or 3 disease. Median radiation dose received was 70 Gy and the median doses of carboplatin and paclitaxel were AUC 1 and 40 mg/m². Patients received a median of 7 cycles of chemotherapy. At a median follow up of 22 months (range 0.5 – 83.6), the 2-year rates of LRC, DC, PFS, and OS rates were 90.4%, 93.5%,78% (95% CI: 67% – 90%) and 88% (95% CI: 80% - 97%), respectively. There were 4 locoregional failures, 5 distant metastases, and 11 deaths. However, 9/11 deaths occurred in patients without local or distant recurrence. The majority of these deaths were attributed to other medical causes such as upper gastrointestinal bleeds, severe ulcerative colitis, and myocardial infarction. There was one patient with difficulty breathing due to prominent treatment related mucosal edema, which resulted in sudden expiration. <h3>Conclusion</h3> Radiation therapy with weekly carboplatin and paclitaxel is an option for HNSCC patients who are cisplatin-ineligible. Randomized trials are needed to compare carboplatin and paclitaxel with other systemic regimens for this population.

Synchronous Second Primary Malignancies in Hypopharyngeal Carcinoma: Prevalence, Clinical Outcomes and Risk Factors

<h3>Purpose/Objective(s)</h3> Hypopharyngeal carcinoma (HPC) is one of the most devastating malignancies among head and neck cancers. Our aim is to explore the prevalence of hypopharyngeal carcinoma (HPC) with synchronous second primary malignancies (Syn-SPMs) and its impact on clinical outcomes and risk factors in the image-enhanced endoscopy era. <h3>Materials/Methods</h3> Totally, 673 consecutive patients who were newly pathologically confirmed HPC were retrospectively reviewed in our center. Patients were classified as two groups: (a) N-SPMs group, (No-second primary malignancies, n=593), or (b) Syn-SPMs group (n=80). The N-SPMs group were defined as patients had no SPMs within 6 months of the index tumor. While for the Syn-SPMs group, patients developed SPMs within 6 months of the index tumor. <h3>Results</h3> The median follow-up time of the whole cohort (n=673) was 66.7 months. The 5-year OS and DSS of the whole cohort were 42.5% and 48.5%, respectively. There were 11.9% (80/673) patients diagnosed with Syn-SPMs. Among these, esophagus was the most frequent site (58/80, 72.5%), followed by head and neck region [HN-region, 16.3% (13/80)], lung (6.3%, 5/80), thyroid (2.5%, 2/80), stomach (1.2%, 1/80) and rectum (1.2%, 1/80). The Syn-SPMs group had a significantly worse 5-year OS of 27.5% compared with that of 44.7% (P<0.001) in N-SPMs group. Moreover, the 5-year DSS between the Syn-SPMs and N-SPMs groups was 40.4% versus 49.5%, though without significantly difference (P=0.297). The baseline were unbalanced between the two groups, we use six factors to balance. The adjusted 5-year OS was 27.0%, significantly worse than that of 52.9% (P<0.001) in N-SPMs group. Likewise, the 5-year DSS in Syn-SPMs was 40.3%, still lower than 58.8% in N-SPMs group (P=0.019). In multivariate analysis, ECOG scores(P<0.001), had Syn-SPMs (P=0.008), clinical stage of HPC (P<0.001) and BMI (P=0.001) were still independently factors associated with OS. <h3>Conclusion</h3> The total incidence of Syn-SPMs with HPC was 11.9%. Routine screening like image-enhanced endoscopy should be recommended to screen for synchronous second primary malignancies in HPC patients.

An exceedingly rare simultaneous incidental occurrence of synchronous primary malignancies; Invasive Ductal Carcinoma and Renal Cell Carcinoma in a male - A Case Report.

Introduction and importanceSynchronous malignancies are defined as the emergence of one or more tumors which either occur simultaneously or within 6 months of each other. Populations older than 50 years of age are the most vulnerable. Documented prevalence rates of synchronous neoplasia are 4.5–11.7 %. To the best of our knowledge, ours is the first documented case of synchronous primary incidental occurrence of Invasive Ductal Carcinoma (IDC) and Renal Cell Carcinoma (RCC) in a Middle Eastern male. This type of co-occurrence must be borne in mind because such neoplastic occurrence is potentially fatal. Documentation is essential to raise awareness and to decrease the resultant morbidity and mortality.Case presentationWe present a case of a 61-year-old male who presented to our clinic with a 22-day-history of gradual, painless, and disproportionate hypertrophy of his left breast. CT scan revealed incidental breast and right kidney masses. Therapeutic intervention included a modified radical mastectomy with Sentinel lymph node excision along with right radical nephrectomy.Clinical discussionTreatment of our patient was multimodal. Accurate radiological studying together with clinical examination helped us in making a diagnosis. Treatment options for this pathology consist of a combination of surgery and/or adjuvant therapy.ConclusionSynchronous IDC and RCC are an extremely rare co-occurrence, especially in males, particularly Middle Eastern males, and more specifically, those presenting asymptomatically as incidental findings. It is vital to further document and study such cases to establish innovative surgical techniques, screening modalities for males, and to overcome the consequential morbidity and mortality.

Double Primary Malignancies Involving Cutaneous Carcinoma.

Multiple primary malignancies (MPMs) refer to the presence of 2 or more histologically distinct malignant tumors in the same individual. The prevalence of MPMs has increased owing to earlier detection of tumors by screening tests and improved treatment modalities for primary tumors. Although any combination of malignant tumors is possible, reports of MPMs involving cutaneous carcinoma are uncommon in the literature. Herein, we present 2 uncommon cases of synchronous double primary malignancies involving basal cell carcinoma and primary cutaneous mucinous carcinoma as the index tumors, accompanied by a thyroid carcinoma and a thymoma as the second malignancy, respectively. The authors also describe the usefulness of positron emission tomography/computed tomography for detecting occult primary tumors in patients with cutaneous malignancies.

Double Trouble – Synchronous Primary Malignant Neoplasms: A Case Report

Synchronous primary malignancy (SPM) is rare. We herein present a case of gastric carcinoma (GC) and renal cell carcinoma (RCC) to highlight the fact that the occurrence of RCC as a synchronous tumor along with GC is rare and that a high index of suspicion of SPM should be considered before declaring it as a metastasis. A 60-year-old male presented with abdominal pain and vomiting for 4 months, and a mass was incidentally found in the lumbar region. The patient was diagnosed with SPM of the GC and RCC. Chemotherapy was given, followed by total gastrectomy; radical nephrectomy was performed. The patient is currently on follow-up. Complete history taking and thorough physical examination of patients with malignancy is instrumental in ruling out metastasis and other synchronous lesions, especially in GC. Synchronous malignancies should be treated with the multidisciplinary team, as there is no consensus in the treatment protocol

Quadruple Primary Malignancy of the Scalp, Colon, and Prostate in a Single Patient: A Unique Case Report and Review of Literature

Multiple primary malignancies are rare but early detection can be achieved with the advent of advanced imaging techniques. Diagnosis of all synchronous malignancy is vital for planning and favorable outcome. In this study, we present a case of synchronous triple primary malignancy consisting of squamous carcinoma scalp, adenocarcinoma prostate, and adenocarcinoma ascending colon with history of sigmoid colon cancer 11 years back. There were 12 possible treatment options and three alternative treatment sequences. Multidisciplinary tumor board team decided to begin the treatment with hormonal therapy (Enzalutamide/Leuprolide) for advanced metastatic prostate cancers. This was followed by simultaneous surgery consisting of wide excision of the right scalp lesion and right hemicolectomy. After a year of follow-up, patient remained disease progression free. This is the first quadruple malignancy case described in literature with the combination of scalp, prostate, and colon cancers as triple synchronous malignancy. Each cancer had its own diagnostic and treatment dilemma. Collectively, sequence of management of each cancer was also a predicament. Multidisciplinary management plays a pivotal role in the successful management of synchronous malignant tumors.

A rare case of synchronous multiple primary malignancies of breast cancer and diffuse large B-cell lymphoma that responded to multidisciplinary treatment: a case report

BackgroundMultiple primary malignancies of breast cancer and diffuse large B-cell lymphoma (DLBCL) are rare. Here, we report a case of advanced breast cancer and DLBCL managed with multidisciplinary therapy preceded by surgery with a successful outcome.Case presentationDuring a medical examination, a 71-year-old woman was diagnosed with a right breast mass, enlarged lymph nodes throughout the body, and a splenic tumor. The results of the clinical examination and imaging were suggestive of widely spread breast cancer with lymph node metastasis and malignant lymphoma with systemic metastasis. The histological evaluation of the biopsied breast tissue revealed human epidermal growth factor receptor 2 (HER2)-positive breast cancer, whereas the histological evaluation of the excised inguinal lymph node revealed DLBCL. 18F-FDG PET/computed tomography was performed, and it was determined that both breast cancer and DLBCL were in an advanced stage. Thus, mastectomy was performed, and the axillary lymph nodes showed mixed metastasis of breast cancer and DLBCL. Soon after, the R-CHOP therapy was initiated (375-mg/m2 rituximab, 2-mg/m2 vincristine, 50-mg/m2 doxorubicin, 750-mg/m2 cyclophosphamide, and 125-mg methylprednisolone). After irradiation of the spleen, trastuzumab was administered for 1 year.ConclusionsWe experienced a case of combined breast cancer and DLBCL, which was difficult to treat because both were in advanced stages. Thorough staging of the malignancy and discussion by a multidisciplinary team are necessary to determine the optimal treatment strategy.

Synchronous Malignancies Identified by PET-CT Scan in Breast Cancer Patients.

Breast cancer is a common malignancy and a common cause of cancer-related mortality in women. Pre-treatment workup of breast cancer does not routinely include positron emission tomography scans. We aimed to review cases of women with breast cancer and a synchronous second primary malignancy. We present three cases of women with non-metastatic cancer in whom a synchronous second primary malignancy was found. Synchronous, second primary malignancies which were identified included rectal cancer, gastrointestinal stromal tumor, and non-small cell lung cancer. All second primary malignancies were identified by a PET-CT scan. In conclusion, PET-CT may be used for detection of secondary primary malignancies in select breast cancer patients.

Synchronous double primary malignancies of the pancreatic body and extrahepatic bile duct treated with pancreatoduodenectomy and splenic artery resection following neoadjuvant chemotherapy with gemcitabine plus nab-paclitaxel: a case report

BackgroundPrimary pancreatic cancer with synchronous primary tumors in other organs is a rare condition, and its treatment largely depends on the progression of pancreatic cancer. Here, we describe a rare case of double primary malignancies involving borderline resectable pancreatic body and extrahepatic bile duct cancers that were successfully resected after neoadjuvant chemotherapy (NAC), subsequently avoiding total pancreatectomy.Case presentationA 61-year-old Japanese male was referred to our hospital by his general practitioner after presenting with elevated liver enzymes during a routine check-up for type 2 diabetes mellitus. He was diagnosed with synchronous borderline resectable pancreatic cancer in the body of the pancreas and lower extrahepatic bile duct cancer with obstructive jaundice. Abdominal computed tomography (CT) confirmed a hypovascular mass in the pancreatic body with partial encasement of the common hepatic artery, left gastric artery, celiac artery, and splenic artery and invasion of the splenic vein. Endoscopic retrograde cholangiopancreatography and bile duct biopsy confirmed lower bile duct cancer. Following multidisciplinary discussion, endoscopic retrograde biliary drainage was performed, and neoadjuvant chemotherapy comprising gemcitabine plus nanoparticle albumin-bound paclitaxel (GEM + nab-PTX) was administered. After a total of seven cycles of chemotherapy, follow-up CT showed that the size of the pancreatic lesion reduced, following which the patient underwent pancreatoduodenectomy with splenic artery resection. The postoperative course was uneventful without any surgical complications or intensive hypoglycemic treatment. The pathological diagnosis was pancreatic ductal adenocarcinoma (ypT3N1aM0 ypStage IIB/UICC 8th) with synchronous extrahepatic cholangiocarcinoma (ypT2N1M0 ypStage IIB/UICC 8th). R0 pancreatic resection was performed with an Evans grade III response to neoadjuvant chemotherapy. The patient was followed up and had no tumor recurrence at 22 months after surgery with adjuvant S-1 chemotherapy, however, died after 32 months after surgery due to multiple liver metastasis and para-aortic lymph node metastasis despite salvage GEM + nab-PTX chemotherapy.ConclusionIn our case, neoadjuvant chemotherapy for borderline resectable pancreatic cancer and function-preserving pancreatoduodenectomy (R0 resection) for double primary malignancies achieved balanced patient survival and postoperative quality of life.

MDCT diagnosis of synchronous primary gastrointestinal tract carcinoma and other solid malignancies: case series study

BackgroundThe presentation of synchronous multiple primary tumors is rare. The aim of this report was to report an uncommon series of cases diagnosed with synchronous gastrointestinal tract carcinoma and other solid malignancies by multidetector computed tomography.Case presentationOur report included 34 patients with synchronous gastrointestinal tract carcinoma and other solid malignancies from November 2009 to September 2019. They were 14 men and 20 women (mean age, 65.5 year; range, 52–82 years). The highest number of GIT cases were colonic carcinomas detected in 70% (24/34) of the patients. The most frequent extra-gastrointestinal primary malignancy sites were renal cell and breast carcinomas, 17.6% (6/34) of each.ConclusionsCareful preoperative evaluation is recommended to detect this pattern of synchronous extra-gastrointestinal tumors. More reports of such cases should help to clarify the pathogenesis of this phenomenon and may lead to a new treatment strategy for synchronous gastrointestinal malignancy and other solid malignancies.

Synchronous primary malignancy of breast and endometrium in premenopausal women - A rare case report

Synchronous primary malignancy of breast and endometrium in premenopausal women - A rare case report

Synchronous primary malignancies and pre-cancers affecting entire hysterectomy specimen: A report of an unfortunate case

Synchronous primary malignancies and pre-cancers affecting entire hysterectomy specimen: A report of an unfortunate case

Multi-detector computed tomography evaluation of synchronous hepatocellular carcinoma and other solid malignancies.

To review the findings of multi-detector computed tomography (MDCT) in synchronous hepatocellular carcinoma (HCC) and other solid malignancies. A total of 74 cases were included in this retrospective analysis, all of them confirmed with a diagnosis of synchronous HCC and other solid malignancies. They were 41 women and 33 men (mean age, 63.36 years). The whole body and triphasic abdominal CT scanning utilized 128 MDCT scanners in all 74 patients. The pathological diagnoses of all 148 malignancies were confirmed in all 74 cases. Out of 3480 patients with HCC, 74 patients (2.1%) were diagnosed with another synchronous primary solid malignancy. The pathology of all 148 cancers was verified, and each one was correctly characterized, assessed, and staged. Hepatocellular carcinoma was detected in all 74 patients. The most frequent extra-hepatic primary malignant sites were breast (18/74, 24.3%), followed by kidney (15/74, 20.3%), lymphoma (9/74, 12.2%), uterus (7/74, 9.5%), ovary (5/74, 6.8%), colon (5/74, 6.8%), prostate (5/74, 6.8%), urinary bladder (3/74, 4.1%), thyroid (2/74, 2.7%), gall bladder (1/74, 1.4%), stomach (1/74, 1.4%), pancreas (1/74, 1.4%), esophagus (1/74, 1.4%) and lung (1/74, 1.4%). The possibility of synchronous double malignancies with HCC should always be considered during pretreatment evaluation. Using an MDCT scanner, researchers were able to assess this occurrence accurately. An increased number of such findings may lead to an improved therapeutic method for these patients.