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[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.

Adult

[Primary, multiple neoplasms in gynecologic carcinomas].

Among 4358 malignant tumours of the female genital tract during a period of 15 years (1958 to 1972) there were 108 primary multiple cancers, of them 53 as first tumours prior to and 55 as second tumours during or after genital carcinoma. The different localisations are demonstrated by tables. The number of the second tumours occured after carcinoma of the cervix and the corpus uteri are compared with a calculated rate of incidence. A satisfacting agreement of the levels allows the conclusion: Primary multiple carcinoma determined by accident and corresponds to the general expectation of carcinoma.

Breast Neoplasms

Multiple primary neoplasms and the nervous system.

Studies of multiple primary neoplasms and their relation to the nervous system should consider two important principles: 1) neoplasms of the nervous system have certain unusual features that distinguish them from tumors occurring elsewhere in the body; and 2) there is good evidence that the various histologic types of nervous system tumors should be regarded as separate diseases. The association of nervous system neoplasms and tumors of other sites may occur in patients with phacomatoses or particular genetic syndromes. In addition, certain nervous system neoplasms may be multicentric in origin. Retinoblastoma and osteosarcoma occur together in the same patient more often than expected by chance, as do meningioma and breast cancer. These relationships are important in that they serve to identify the high risk patient, may provide etiologic clues, may point to the presence of genetic syndromes, and may highlight sites in which subsequent tumors are most likely to develop.

Brain Neoplasms

Clinical aspects of multiple primary neoplasms.

We review the medical literature for the clinical characteristics of patients developing multiple primary neoplasms (MPN). Also, preliminary results of our study at Memorial Sloan Kettering Cancer Center are reported. Although there have been very few specific reports on this topic, it was possible to find some data, suggesting a worse prognosis for patients with MPN. Several factors may be responsible for this, and further studies are in progress. Meanwhile, it is of great importance to decrease the incidence of cancer by prevention, such as reducing smoking and alcohol consumption. This may reduce the incidence of first primary neoplasms and MPN. Optimal treatment for the first primary neoplasm should be given, but the possible risk of MPN should be taken into consideration, and, if there are two alternatives for the treatment of the first tumor, the one that is less carcinogenic and that will allow appropriate therapy for a second primary neoplasm (MPN2) should be chosen. On follow-up of cancer patients, a low threshold of suspicion for a second primary neoplasm is recommended to detect them early for possible curative treatment. Because of the poor prognosis, more aggressive treatment regimens for MPN are warranted.

Breast Neoplasms

[Multiple primary neoplasms].

In the years 1980-1987 in the Department of Internal Diseases, Silesian Medical Academy in Katowice 32 patients were observed with multiple malignant neoplasms of various organs. The time from the diagnosis of the first neoplasm to the appearance of the second one was from 0 to 168 months (mean 61.8 months). The second neoplasm developed in over half the cases (53.1%) after more than 5 years from the first one. The most frequent first neoplasms were: Hodgkin's disease and breast carcinoma, and the most frequent second neoplasm was colonic carcinoma, gastric carcinoma and endometrial carcinoma. The necessity of prolonged observation of patients with malignant neoplasms during many years is stressed.

Adolescent

Multiple primary neoplasms in blacks compared to whites. IV. Further cancers in patients with cancer of the digestive organs.

Second primary cancers found among whites and blacks with initial cancer of the digestive organs were reported based on data from the Charity Hospital Tumor Registry. Observed second primary cancers were compared to expected numbers to obtain a direct estimate of risk. Both white and black men had about a twofold risk of developing a second cancer. For white men, the excess was limited to a subsequent skin cancer, but this finding was probably an artifact of reporting and lacked biologic significance. Among women, both white and black, large excesses of invasive cancer of the cervix and ovary were found after an initial cancer of the large intestine and anorectum was discovered. No excess of breast cancer was found.

Black or African American

[Systemic hemangiomatosis combined with multiple primary neoplasms].

An observation of the systemic haemangiomatosis with the involvement of the small bowel and brain in a 59-year-old man who died from the edema and dislocation of brain is described. The peculiar feature of this observation lies in both rarity of this lesion and its combination with benign and malignant tumours of internal organs.

Adenocarcinoma, Bronchiolo-Alveolar

[A synchronous association of a double colonic adenocarcinoma and hypernephroma: an infrequent case of multiple primary neoplasms].

It has been reported that exceptional association exists between primary colon cancer and hypernephroma. In this paper we are reporting a case of a male patient carrying an hypernephroma synchronous with a proximal colonic adenocarcinoma in addition to a second adenocarcinoma, growing on a tubular adenoma, nearly of first. These findings get seen as partially coincidental with some features of the cancer family syndrome (Lynch syndrome II), and we have considered that genetics conditions, like those of Lynch syndrome II, could to explain some multiple neoplasms in patients carrying then.

Adenocarcinoma

[A hundred cases of multiple primary neoplasms in association with genitourinary cancer].

There were 970 patients who were diagnosed as having genitourinary cancer at Yamagata Prefectural Central Hospital between 1975 and 1990, and of whom 100 cases (10.3%) had multiple primary malignant neoplasms in addition to their genitourinary cancer. They were compared with 220 patients having single genitourinary cancer and 274 having benign prostatic hypertrophy without past histories of cancer. The genitourinary organs involved with cancers included the prostate (50 patients), urinary bladder (43 patients), ureter or renal pelvis (15 patients) and kidney (7 patients). In the prostate cancer, the incidental carcinomas occupied 30%. The other organs accompanying the genitourinary cancers included the stomach, lung and colon. In patients of multiple primary cancers, single genitourinary cancer and benign prostatic hypertrophy, positive family histories for cancer were observed in 40.0%, 37.7% and 33.2%, respectively, with no significant difference between these groups. Histories of smoking were observed in 54.0%, 38.2% and 34.3% respectively, with significant difference between the multiple primary neoplasm patients and the other 2 groups (p < 0.01). There were two cases in whom the second cancer could be possibly caused by the exposure to radiation for the first cancer. No oncotherapeutic drugs or occupational exposure could be seriously suspected of the cause of the second cancers in the present cases.

Adult

[Multiple primary malignant neoplasms of the large intestine].

Of the 3182 patients with malignant tumors of the large intestine, in 140 (4.4%), the primary multiple malignant neoplasms were revealed: in 59 (42.1%) of them--the synchronous, in 81 (57.9%)--the metachronous ones. Surgical treatment was performed in 137 (97.9%) patients, including the radical treatment--115 (83.9%). The postoperative lethality was 7.3%. 75.3% of the patients are alive for five years, 21.3%--for ten years.

Adult

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.

Adult

[Primary multiple brain neoplasms].

A rarely encountered case of primary multiple brain tumours is discussed: polymorphic cellular astrocytoma of the frontal and temporal lobes of both hemispheres of the brain and fibroblastic arachnoid endothelioma of the right temporal area. Intravital diagnosis of such tumours was extremely difficult due to the prevalence of general suprafocal symptoms in the brain.

Arachnoid

[Non-specific immunologic reactivity among patients with primary multiple malignant neoplasms].

Under examination were seventy four patients with different combinations of primary multiple malignant tumors. In patients with 2 skin tumor nodes a high percent of delayed allergic reactions was found in response to the use of 2,4-dinitrochlorobenzene (DNCB) and a correlated with the former high coefficient of the percutaneous test with tripan blue (QD). The mentioned indices are diminished as the third or more skin tumor nodes appear. In polyneoplasia involving internal organs delayed allergic reactions were found to be absent and QD markedly reduced.

Adult