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Differences of clinical features, prognosis and genetic mutations in Chinese patients with malignant melanoma and additional primary tumours.

BACKGROUND: The differences in the clinical features, prognosis and genetic mutations in Chinese patients with malignant melanoma (MM) and additional primary tumours remain unclear. METHODS: A retrospective analysis was conducted on patients with malignancies in Fujian Cancer Hospital from January 2007 to September 2022, end follow-up in September 2023. Clinical data were gathered, survival analysis was performed, and genetic mutations were detected. RESULTS: There were 58 of 1223 melanoma patients with melanoma and additional primary tumours, an incidence of 4.74%. Acral MM was the most common subtype (26/58), 23 (39.66%) patients had concomitant digestive tumours. Patients who had MM as their first primary tumour (MMFP) had shorter tumour occurrence intervals (9.93 vs. 57.78 months, p = .008) but longer melanoma survival (MM-OS) than the non-MMFP group (100.43 vs. 18.93 months, p = .015). Patients with cancer family histories were more likely to have pathogenic and likely pathogenic (P/LP) mutations (2/5 vs. 4/25). The somatic BRAF gene mutation was frequently observed in MM tissue (8/19, 42.11%). Three patients had whole-genome doubling and microsatellite instability-high (MSI-H). The COSMIC2 signature 3 was significantly higher in the P/LP group. CONCLUSIONS: The frequency of MM and additional primary tumours is about 5% in Chinese populations. Patients with melanoma diagnosed first have longer melanoma survival. Digestive system tumours were the most concomitant; a digestive examination is advisable, especially for those with an expected overall survival (OS) greater than 10 months. Meanwhile, patient's family cancer history should be followed up in detail, along with completion of germline P/LP mutation and somatic mutation testing, all of which may provide valuable support for further treatment.

Adult↗

[Multiple primary cancer and radiation-induced cancer of the uterine].

This report is concerned with multiple primary cancers developing in invasive uterine cancer. Second primary tumors were recorded 27 women with a total of 30 non-uterine cancer (exception of radiation-induced cancer). 17 patients of radiation-induced neoplasm were observed (Rectal cancer 4, soft part sarcoma 4, cancer of urinary bladder 3, bone tumor 3, uterine cancer 2 and cancer of Vulva 1). One case is 4 lesions (corpus, sigma, thymoma and stomach), 2 cases are 3 lesions (uterine cervix, stomach and maxillary sinus: uterine cervix, thyroidal gland and radiation-induced soft part sarcoma). Only 5 of these 17 patients were known irradiated dose (50 Gy approximately 55 Gy), however others unknown. The mean latent periods of 17 cases of radiation induced neoplasms are 19.4 years. 16 patients of late second cancers of the cervix appearing from 11 to 36 years (average 19.5 years) after initial radiotherapy were recorded.

Adult↗

Different clinical features of primary and secondary tumors in patients with multiple malignancies.

Clinical features of the first and second primaries in patients with multiple malignancies have not been extensively studied. We compared patient and treatment characteristics of the primary malignancy in 48 consequent multiple primary cancer patients with those of the second primary in the same cohort. The second primaries comprised fewer breast cancers; 29.2% of primaries as opposed to 10.4% of second tumors were breast cancer (P = 0.049). In addition, primary tumors tended to be at a lower TNM stage than secondary tumors (P = 0.060). The median overall survival after the diagnosis of the first primary for the whole cohort was 22.3 years (95% CI, 2.0-42.5) and the median time to presentation of the second malignancy was 38 months after the diagnosis of the first primary (range, 0 to 384). Therefore, the prognosis of cancers in the multiple malignancy group appears to be good and they appear to have an indolent clinical behavior. Thus, we recommend a long screening time for secondary tumors after a curative treatment in patients with common cancers, taking into account the different occurrence patterns of second primaries with respect to first primaries.

Adult↗

Second primary cancer following treatment for cervical cancer.

A follow-up study of 7535 women in Ontario was carried out to assess the occurrence of second primary cancers following the treatment of invasive carcinoma of the cervix between 1960 and 1975. The study was part of a larger international investigation of late radiation effects in patients with cervical cancer. Data were collected on the date and the type of treatment for cervical cancer and on the occurrence of second primary cancers diagnosed before 1980. Observed and expected numbers of second primary cancers, the latter determined according to Ontario incidence rates, were compared for individual sites and for all sites combined. There were significantly more primary cancers of the lung than expected (64 v. 15.52) but significantly fewer second primary cancers of the breast (56 v. 105.01) and colon (27 v. 43.31). Overall, there were significantly fewer (p less than 0.05) observed second primary cancers than expected (280 v. 394). Although the median follow-up period was less than 10 years there was no marked evidence of an excess of radiation-induced second primary cancers.

Carcinoma↗

Rhabdomyosarcoma and late malignant melanoma of the orbit.

Forty-five years following surgical excision and radiation for a childhood rhabdomyosarcoma of the left orbit, a patient with primary lymphedema developed an ipsilateral malignant melanoma of the anterior orbital tissue. This was excised, but a metastasis of the melanoma occurred in the contralateral upper lid. This is the first case report of treated rhabdomyosarcoma of the orbit followed by a second primary tumor occurring in the field of radiation.

Eyelid Neoplasms↗

Granular cell myoblastoma of the esophagus after irradiation for carcinoma.

Granular cell myoblastoma is an uncommon, usually benign tumor. Only 20 cases are reported in the esophagus. We describe a 65-year-old woman who developed a granular cell myoblastoma of the postericoid esophagus in the area of a squamous cell carcinoma successfully treated with irradiation. To our knowledge, this is the 21st reported case, and the only case occurring in the esophagus after irradiation for primary squamous cell carcinoma.

Aged↗

Multiple synchronous and metachronous neoplasms of the parotid gland: the Chichester experience.

Parotid neoplasms are usually solitary and multiple tumours occurring in an individual are uncommon. The incidence and implications of multiple synchronous and metachronous tumours remains relatively unknown. We reviewed the case notes of 606 patients who had parotidectomies for neoplastic lesions over a 30 year period and identified 30 patients (5%) with multiple primary tumours. There were 24 patients with synchronous tumours and 6 with metachronous tumours. Sixteen of the synchronous tumours (67%) were ipsilateral, whereas all six metachronous tumours were contralateral. Preoperative examination was effective at detecting bilateral tumours but poor at detecting multiple ipsilateral tumours. Multiple tumours were likely to be of the same histology (n=24, 80%) and Warthin's was by far the most common multiple tumour. Ipsilateral tumours of differing histological types and identical tumours other than Wartin's were uncommon. All but one patient had superficial parotidectomies and there were no recurrences.

Adenocarcinoma↗

Some aspects of multiple esophageal and gastric cancer.

This paper deals with data on 65 patients with multiple primaries. There were synchronous and metachronous, double carcinomas of the esophagus (8), carcinomas of the esophagus and stomach (18), esophagus and lung (10), and stomach and lung (29). Problems of diagnosis and treatment results are discussed. Indications for surgery should be determined by the extent of the two primaries. Only radical surgery with extirpation of both tumors may lead to relatively favorable results. The treatment only of single carcinoma (either by surgery, or radio- and chemotherapy) is not beneficial in patients with synchronous lesions. Thorough attention should be given to the patient's complaints and adequate follow-up investigation pursued in order to detect second (and following) primaries as soon as possible.

Aged↗

Long-term consequences of CNS treatment for childhood cancer, Part I: Pathologic consequences and potential for oncogenesis.

The pathologic changes associated with the treatment of cancer of the nervous system are reviewed. Computed tomographic, magnetic resonance imaging, and positron emission tomographic findings of these abnormalities are described, followed by discussion of the known histopathologic features. For the most part, pathologic effects are primary vascular and/or demyelinating. We review each of these effects at all levels of the neural axis. This review concludes with a discussion of the risk of developing second malignancies. Although this complication is infrequent, the likelihood that survivors of childhood cancer will develop a second malignancy is 10 times that of age-matched controls. This phenomenon in part relates to genetic predisposition, environmental factors, and host susceptibility. These qualifications not withstanding, most studies implicate central nervous system radiation with and without chemotherapy as the primary etiology for second malignancies.

Antineoplastic Agents↗

Caldwell Lecture. Giant cell tumor of bone: highlights of 407 cases.

This retrospective study of 407 cases of giant cell tumor indicated that most tumors were in the expected locations, usually in the end of a major tubular bone. Female patients accounted for a definite, but slight, majority. Five patients had metaphyseal tumors, and three patients had multifocal tumors. Only one tumor occurred in a lesion of Paget disease. Local soft-tissue implantation, ordinarily with the implant having a mineralized shell, was observed in 10 of the cases. Eight patients had tumors that produced benign metastatic lesions, and two of them have died. Histologically, malignant change developed in 28 of the cases; in 21 of these, radiation had been included in the treatment of the primary lesion.

Adult↗

[Multiple primary tumors of the lung (autopsy reports)].

Primary multiple malignancies were identified in 67 cases (3.55%) as a result of evaluation of 2,000 autopsy reports on deaths from lung cancer filed in Petrozavodsk and St. Petersburg. Eighty eight cases of primary multiple malignancies of the lung are discussed. A second tumor was found to be localized most frequently in the organs of respiration and digestion.

Autopsy↗

A case with quadruple primary cancers of head and neck.

Despite progress in techniques for early detection and treatment of cancers, cases of multiple primary cancers are apparently increasing. This paper reported quadruple primary cancers of stomach, lung, hypopharynx and maxillary sinus in a 63-year-old male. He finally died of brain metastasis and pneumonia by MRSA (Me Resistant S. aureus).

Adenocarcinoma↗

Disseminated melanomatosis of the central nervous system and other organs: a case report.

This case represents an example of clinically occult, disseminated neoplastic disease with almost asymptomatic but severe involvement of the central nervous system. The only helpful diagnostic investigation appeared to be cerebrospinal fluid cytology. Extensive post mortem examination was inconclusive as to whether the widespread CNS involvement with melanoma was primary or secondary.

Brain↗

[Multiple Carcinomas. Results of 2 813 autopsies (author's transl)].

The presence of multiple primary malignant neoplasms has been proved pathologically in a total of 50 cases recorded during a 5 years period (1970-1974). The 50 patients represented an incidence of 5.4% among the 992 patients proved to have cancer during the same 5 years period. The multiple lesions were diagnosed simultaneously in half of the patients. Twenty six patients had consecutive neoplasms, the average interval between the first and the second cancer was 6.9 years.

Age Factors↗