Multiple primary malignant neoplasms

The occurrence of multiple malignant tumours has been recorded, usually as individual cases but also in groups from tumour registries or autopsy studies. A personal series of 71 cases encountered in the follow-up clinics of two District General Hospitals is presented. Cases of multiple skin tumours, and of intestinal growths associated with pernicious anaemia, ulcerative colitis and familial polyposis have been excluded. Review of the literature has been carried out and possible aetiological factors have been considered. The importance of the functions of the tumour surveillance mechanism is emphasized, and the possibility of depression of the defence mechanism by major surgery, is considered to be of importance. Assessment of the patient's defence mechanisms may be as important as grading and staging the tumours.     

Multiple primary malignant neoplasms

A 75-year-old man developed neurilemmoma of the left eighth cranial nerve, adenomatous polyp of the sigmoid colon, adenocarcinoma of the prostate, mixed cell type lymphoma of the right neck, and infiltrating ductal carcinoma of the right breast metachronously during a period of 38 years. The cancer of the right breast occurred 7 years after the long-term stilbestrol treatment of prostatic carcinoma, which suggests a causal relationship between the hormonal therapy and development of breast carcinoma.     

Multiple primary malignant neoplasms

Indian Journal of Otolaryngology and Head & Neck Surgery - A case of multiple primary malignant neoplasm is presented. The patient had carcinoma of uvula and oesophagus with leukoplakia of...     

Evolution and advances of the lateral surgical approaches to cranial base neoplasms

Summary The evolution and advances of the lateral surgical approaches used for neoplasms of the cranial base involving the middle and posterior cranial fossa are reviewed. The lateral approaches available for access to the cranial base are diverse and are often used in combination. Approaches for tumors that are completely extradural, usually involving the temporal bone or infratemporal fossa, include the infratemporal fossa approach described by Fisch and the preauricular subtemporal-infratemporal fossa approach. Lateral approaches used to provide exposure of intradural tumors involving the clivus and traversing the middle and posterior cranial fossa are based on the following approaches: the frontotemporal orbitozygomatic, subtemporal/middle fossa, transpetrosal, lateral suboccipital, and transcondylar approaches. The great strides that have been made in the safe and effective surgical treatment of cranial base neoplasms are due, in part, to the availability of multiple surgical approaches and the ability to tailor the planned operative procedure to the precise location and extent of the cranial base tumor.     

Multiple malignant neoplasms in patients with nasopharyngeal carcinoma

The records of 759 patients with nasopharyngeal carcinoma were reviewed. Fifteen of them also suffered from another malignant neoplasm. All patients had histological confirmation of the nasopharyngeal carcinoma and the other malignant neoplasm. There was no predilection for the second malignant neoplasms to arise from the bronchus. Although the observed number of second malignant neoplasms was not significantly different from the expected number (p greater than 0.05) computed by the patient-month approach, in 1 patient the second malignant neoplasm may be causally related to the previous treatment of nasopharyngeal carcinoma by radiotherapy.     

Multiple primary neoplasms at a single institution: differences between synchronous and metachronous neoplasms

During the 10-year period (1987-1996) of our study, 26,255 patients with cancer were admitted to our clinic and, of these, 271 (1%) patients had multiple primary malignant tumors. Ninety-two (34%) patients had synchronous tumors (synchronous group), and 179 (66%) patients had metachronous tumors (metachronous group). The mean age at first diagnosis was higher in the former group. The ratio of men to women was 1.36 in the synchronous group and 0.74 in the metachronous group (p = 0.018). Smokers and drinkers were more common in the synchronous group. Breast cancer and lung cancer were most prevalent, and associations between head/neck and lung cancer and between breast and breast cancer were the most frequent associations in both the synchronous and the metachronous group. The frequency of aerodigestive tumors was higher and that of mesenchymal tumors was lower in the synchronous group than in the metachronous group. Localization in the medial region and in the head/neck was more frequent in the synchronous group than in the case of metachronous secondary tumors.     

Multiple sebaceous neoplasms and visceral carcinomas: Torre's syndrome

The association of sebaceous neoplasms with visceral carcinomas is recognized as Torre's syndrome. A classical example of this interesting syndrome is reported. The familial predisposition to colorectal carcinoma is emphasized.     

Multiple primary malignant neoplasms of the head and neck

This report analyzed the 7,763 cases treated at T.W.M.C., where radiotherapy has been mainly used, between 1968 and 1984. Of these, 258 cases (3.3%) had multiple primary malignant neoplasms, among which 88 cases involved head and neck cancer. The incidence averaged 1.6% during the first 5 years, but increased to an average of 5.7% during the last 5 years. Among head and neck cancer the incidence of multiple primary malignant neoplasms was 8.5% (88/1,033) and the incidence has been gradually increasing annually. Cancers of the head and neck were frequently combined with another primary lesion in the head and neck area or in the digestive tract, especially esophagus and stomach, followed by one in the both cases. The great majority of cancers in the head and neck occurred as the first cancer at age 60-70. The head and neck region is where the respiratory system and digestive system, including lymphatic organs originate and where the external carcinogenic factors enter into the body. These data suggested that multiple primary malignant neoplasms have been increasing in number and becoming an increasing problem. The possibility of multiple primary malignant neoplasms should not be forgotten in routine cancer related clinical work.     

Multiple primary malignant neoplasms in breast cancer patients in Israel

The data of an epidemiologic study of multiple primary malignant neoplasms in breast cancer patients in Israel are presented. During the 18-year period of the study 12,302 cases of breast carcinoma were diagnosed, and, of these, 984 patients (8%) had multiple primary malignant tumors. Forty-seven of these patients developed two multiple primary cancers. A significantly higher than expected incidence of second primary cancers occurred at the following five sites: the opposite breast, salivary glands, uterine corpus, ovary, and thyroid. Cancers of the stomach and gallbladder were fewer than expected. Treatment of the breast cancer by irradiation was associated with an increased risk of subsequent cancers of lung and hematopoietic system. The prognosis was mainly influenced by the site and malignancy of the second primary cancer. The incidence of multiple primary malignancies justifies a high level of alertness to this possibility in the follow-up of breast cancer patients.     

Multiple cranial nerve palsies as the presenting features of prostate carcinoma

Cranial nerve palsies have previously been reported in metastatic prostate carcinoma, usually occurring late in the course of the disease. We describe the case of a 55-year-old man whose diagnosis of prostate cancer was made following investigation of multiple cranial nerve palsies.     

Multiple primary neoplasms in patients with multiple myeloma and primary macroglobulinemia

A review of 65 patients with multiple myeloma (MM) and 10 patients with primary macroglobulinemia (PM) seen at our clinic from 1972 through 1988 revealed further cancers that were found in 11 patients with MM and in 2 patients with PM. In 4 of 13 patients with multiple primary neoplasms, either MM or PM was an antecedent. In 6 patients, MM or PM was coincident with the cancers. In 3 patients, the cancer was antecedent. Only one patient with multiple myeloma developed secondary leukemia following treatment with alkylating agents.     

Multiple primary tumours in women with vulvar neoplasms: a case-control study

We sought to determine whether women with in situ or invasive squamous cell vulvar cancer were more likely than other women to have had a previous or concurrent tumour at other anogenital sites. One hundred and fifty-eight women with vulvar cancer were identified who were first diagnosed during 1980-1985, were ages 18-79 years at that time, and were residents of one of three counties in western Washington. Two control groups were selected: (1) from records of hospital pathology departments, a sample of 113 women with certain benign conditions of the vulva; (2) through random digit dialing, a sample of 212 women from the general population of these counties. Information on a history of other cancers, and on sexual, reproductive, medical, and demographic characteristics was collected from cases and controls in at-home interviews. Cases were more likely to report a history of other anogenital cancers than were controls, with relative risks of 3.5-29.8, depending on the type of case group and type of control. These associations were not explained by case-control differences in demographic characteristics or frequency of cervical screening. On the other hand, prior or concurrent non-anogenital cancers were equally common in cases and controls. These results support the hypothesis that the different anogenital cancers have at least one aetiology in common.     

Multiple primary neoplasms in association with prostate cancer in black and white patients

The current study follows up the 983 patients who were diagnosed as having prostate cancer at the Columbia-Presbyterian Medical Center in New York City between 1970 and 1979 and of whom 106 (11.5%) developed a multiple primary malignant neoplasm (MPMN) in addition to their prostate cancer by January 1, 1986. Of the 283 black patients, 32 (11.3%) developed an MPMN involving 35 sites excluding prostate. Of the 636 white patients, 74 (11.6%) developed an MPMN in association with their prostate cancer. Comparing observed incidence rates to expected on the basis of SEER incidence data, two malignant tumors, urinary bladder cancer and malignant lymphoma, appeared to occur in excess in the present series of patients. The excess of urinary bladder cancer in our series could be explained by detection bias due to the routine use of cystoscopy. The excess incidence of lymphoma in our series appears significant but its etiology is unexplained.     

Multiple neoplasms in two siblings with a variant form of Fanconi's anemia.

Two siblings with a variant form of Fanconi's anemia developed multiple neoplasms after prolonged survival and treatment with androgens. One of the siblings developed two separate oral squamous cell carcinomata, and the other developed acute leukemia and hepatoma. Androgens may have had a carcinogenic role in the appearance of the hepatic neoplasm. There is an increased incidence of neoplasm associated with Fanconi's anemia. This may be related to frequent spontaneous chromosomal abberations and/or to increased cellular susceptibility to viral transformation.     

Multiple spinal metastases of cranial gliosarcoma: a case report and review of the literature

Gliosarcoma is a rare brain tumor that consists of both glial and mesenchymal components. We report the case of a 68-year-old female with cranial gliosarcoma metastatic to the spinal cord. Initially, the patient was diagnosed with cranial gliosarcoma and treated with surgical resection followed by radiotherapy. Four months after she completed treatment, she presented with a sudden onset of hemiplegia. MRI (Magnetic Resonance Imaging) scan demonstrated two masses at the thoracic spinal cord. Immediate surgery was performed and the lesions were resected. No further therapy was recommended due to the poor condition of the patient. The patient subsequently died 3 months after diagnosis of the spinal cord metastases. There are about 20 reported cases of metastatic gliosarcoma and most focus on systemic metastases of gliosarcoma. Spinal cord metastases are, however, very rare and here we report such a case. Available literature on metastatic gliosarcoma was also reviewed.     

Multiple primary malignant neoplasms: case report and a comprehensive review of the literature

A case is presented of an elderly patient with synchronous ureteral/bladder/urethral transitional cell carcinoma and prostatic adenocarcinoma. In a subsequent review of 1,104,269 cancer patients in the literature, the reported prevalence of multiple primary malignant neoplasms (MPMN) varies between 0.734% and 11.7%. It appears that MPMN might occur more frequently than can be explained on the basis of random chance. As expected, the incidence of developing MPMN is noted to rise with increasing age. In addition, the preponderance of men with MPMN is caused primarily by the high frequency of prostatic cancer. Current studies and research need to address the potential of older cancer patients being at higher risk of second primaries.