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The authors observed 57 patients with primary multiple tumors of various localization. The intervital diagnosis of polyneoplasms was established in 37 patients, the second tumor was found in 20 of 57 cases at the autopsy. 2 neoplastic nodes were found in 52 cases, 3-- in 4 cases, in one case 6 primary multiple neoplasms were found in the sigmoid colon (5 malignant polyps and 1 ulceroinfiltrative carcinoma).
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Restriction fragment length polymorphism in the human c-Ha-ras-1 locus, associated with a minisatellite sequence, was examined in 45 multiple primary cancer (MPC) patients, 56 patients with squamous cell lung cancer (SCLC), 21 patients with lung adenocarcinoma (LAC), and 53 individuals having no oncopathology. Southern analysis of cellular DNA revealed the presence of 4 common alleles (with collective allele frequency close to 94% in the control group) and a set of rare alleles. Allele a3, (2.1 kb in size under MspI/HpaII digestion) was shown to be more frequent in the MPC than in the control group. The same tendency was observed in the patients with highly differentiated cell lung cancer. An increased frequency of the a4 allele (2.5 kb under MspI/HpaII digestion) was observed in the patients with adenocarcinomas as well as in the patients with metastases and low levels of tumor tissue differentiation. The elevated frequencies of a3 in the MPC group and of a4 in the LAC patients did not correlate with increased risk of the cancers mentioned above but was associated with type of tumor progression. Previously, it was reported that the mini-satellite sequence within the c-Ha-ras-1 locus possesses enhancer activity. Our data indirectly confirm the hypothesis that the efficiency of minisatellite modulator activity is associated with fragment size.
A high incidence of multiple primary neoplasms has been observed in our patients with ATL in comparison to persons with other forms of hematologic malignancy who we have observed during the past 23 years (1963-1985). Five of 15 patients with ATL (33.3 per cent) have had at least one other associated neoplasm in comparison to only 44 of 1156 patients with other forms of hematological malignancy (3.8 per cent). The incidence figures for secondary neoplasms associated with the other hematologic malignancies were 4.3 per cent (16/370) for acute non-lymphocytic leukemia (ANLL), 2.2 per cent (2/90) for acute lymphocytic leukemia (ALL), 4.8 per cent (1/21) for acute unclassifiable leukemia, 2.2 per cent (5/225) for chronic myelogenous leukemia, 4.7 per cent (2/43) for chronic lymphocytic leukemia, 5.9 per cent (8/136) for malignant monoclonal gammopathy and 3.7 per cent (10/271) for malignant lymphoma. The incidence of multiple neoplasms in patients with ATL in comparison to those with other hematological malignancies was statistically significant (p < 0.01 or p < 0.001). The neoplasms associated with ATL have been adenocarcinoma of the thyroid or stomach, and squamous cell carcinoma of the larynx, lip or lung. We identified ATL-derived factor (ADF) in the cytoplasm of the secondary neoplasms of the ATL patients by means of indirect immunofluoroscopy and immunohistochemical techniques utilizing anti-ADF antibody. We also identified ras p21 products in these neoplasms by means of p21 ras monoclonal antibody studies. The possibility that HTLV-I was the cause of the secondary neoplasms thus was investigated. HTLV-I provirus genome was not found in all the six cases of non-ATL leukemic cells of the patients with anti-HTLV-I antibodies as determined by means of Southern blot analysis utilizing pX DNA probe. These findings suggest that there is some association between ATL cells and pre-malignant cells through ADF or other unknown factors in the activation of ras oncogenes. Subsequent suppression of host immune defence mechanisms in ATL patients permits evolution of the secondary neoplasms.
A man with large-cell carcinoma of the lung, cerebral meningioma, occult adenocarcinoma of the prostate, and follicular adenoma of the thyroid developed symptomatic, rapidly progressive hypereosinophilia with abnormalities of eosinophil ultrastructure and bone marrow karyotype (45,X,15q22-). Although the patient's eosinophilia defied strict classification as idiopathic hypereosinophilic syndrome (HES), simple tumor-associated eosinophilia, or eosinophilic leukemia, it appeared to be incited by the lung cancer and quickly acquired malignant independence. The family had an excess of prostate cancer and lymphoproliferative neoplasms.
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OBJECTIVE: An epidemiologic study of multiple primary malignant neoplasms i endometrial cancer patients is presented. DESIGN: From 1984-1996 121 endometrial carcinomas have been evaluated in the Department of Gynecology & Obstetrics in Hospital of Słupsk retrospectively. All double and triple neoplasms have been histologically recorded, doubtful cases have been excluded. MATERIAL & METHODS: Of 121 endometrial carcinomas 12 (9.9%) were multiple malignant neoplasms. Of these neoplasms 7 (5.8%) occur together with breast cancer and 5 (4.1%) with other primary malignomas, 11 are double, 1 is triple malignomas. During the 12-year period of study, 23 patients (19.0%) out of 121 patients diagnosed as having endometrial cancer had another primary benign neoplasms. Of these neoplasms 19 (15.7%) occur together with leiomyomas of uterus and 4 (3.3%) with ovarian cysts. The relation of endometriosis to endometrial carcinoma has been subject of only few studies. The investigations have resulted on the association between the conditions. Endomeriosis was found in association with endometrial carcinoma in 12 (9.9%) of 121 cases. In two cases of endometriosis carcinoma developed. CONCLUSION: There is not statistically significant difference in survival rate between group with synchronous primary malignant neoplasms and group with second primary benign neoplasms or group without multiple primary neoplasms (p = 0.07). Patients with endometrial cancer should be carefully and regularly followed up by monitoring at every anatomic site, especially the breast, stomach, and colon, in order that the development of a second primary carcinoma can be detected as early as possible, and not be overlooked in examinations.
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The presence of five discrete synchronous or metachronous primary neoplasms in a single patient is an extremely rare event. This is a report of a patient with a malignant (invasive) thymoma and four other independent primary neoplasms including: gliosarcoma, papillary thyroid cancer, meningioma and metastatic adenocarcinoma of the colon, found synchronously at autopsy. Thymoma patients appear to have an inherent predisposition towards developing additional neoplasms. Other than the thymoma, the presented patient had no obvious risk factors for neoplasia. This case provides evidence for an unusual syndrome of thymoma and multiple primary neoplasms. Further research is required to elucidate the mechanism of this association. Meanwhile, heightened awareness of this association may allow earlier detection and treatment of additional cancers in patients with a history of thymoma.
The high incidence of multiple primary carcinomas occurring in the upper aerodigestive tract is well documented, with the accepted incidence being as high as 20-30%. The full clinical significance of this phenomenon is, however, only now becoming apparent. Herein 548 cases of documented multiple primary neoplasms, presenting initially in the upper aerodigestive tract, are evaluated retrospectively to establish the survival in these patients. The overall 5 years survival rate after diagnosis of the second neoplasm was found to be 22.3% which was significantly lower than a control group. The reasons for this poor survival are considered. These include: 1. the high incidence of second cancers developing in the lung and esophagus which have an extremely poor survival rate; 2. the frequent late diagnosis of the second lesions, with resultant advanced staging, and therefore poor prognosis; 3. inability to institute the appropriate therapy for these lesions due to the effects of previous radical therapy utilized for the first tumor. The clinical implications of this problem are discussed.
The association of a carcinoid tumour with non-endocrine urologic neoplasms is an infrequent finding. This paper contributes one case of multiple primary neoplasm where a prostatic adenocarcinoma coexists with an intestinal carcinoid tumour in a 63-year old asymptomatic patient. Diagnosis of prostate cancer was achieved during a screening for this conditions whereas the intestinal carcinoid tumour was found in the extension study.
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The majority of salivary gland tumours present as a single mass in one gland. Sometimes multiple primary neoplasms can be seen in more than one salivary gland. The most common tumour is Warthin's tumour. Multiple primary pleomorphic adenomas are extremely rare. Most of them are in the major salivary glands. The author reports the first case of simultaneous pleomorphic adenomas in the parotid gland and minor salivary gland at the parapharyngeal space.
The concurrence of multiple sclerosis and primary intracranial neoplasms is uncommon. The literature contains 20 cases of multiple sclerosis associated with gliomas and nine cases with non-gliomatous neoplasms. This report describes a protoplasmic astrocytoma and arteriovenous malformation found incidentally at autopsy of a 63-year-old woman with a 25-year history of multiple sclerosis. This is the first demonstrated association of multiple sclerosis with an arteriovenous malformation. Although neoplastic transformation of reactive glial cells in multiple sclerosis plaques has been proposed as the source of gliomas, the association of multiple sclerosis with astrocytoma and arteriovenous malformation in the present case is considered to be coincidental. Gliomas reported in association with multiple sclerosis are more frequently (30%) multicentric than are uncomplicated gliomas.
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