Five Simultaneous Primary Tumors in a Single Patient: A Case Report and Review of the Literature

Abstract

Multiple primary malignancies (MPMs) are present when a patient is diagnosed with more than one primary malignancy and when each tumor is histologically unrelated to the others. MPMs are considered synchronous when they present within 6 months of one another. Here, we report the case of a 57-year-old woman with a past medical history significant for melanoma in 1988, who presented in 2014 with 5 distinct tumors within 4 months: malignant melanoma of the right popliteal fossa, invasive lobular breast carcinoma, diffuse large B cell lymphoma, nodular lymphocyte predominant Hodgkin lymphoma, and a giant cell tumor of tendon sheath/pigmented villonodular synovitis. We discuss her treatment and also present a brief review of the literature. The incidence of MPMs appears to be on the rise, which demands an interdisciplinary, multimodal, and personalized approach to care.

Breast Cancer and Multiple Primary Malignant Tumors: Case Report and Review of the Literature

“…Breast cancer and skin cancer. Twelve cases of tumors involving the skin and the breast in the same person have been described (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21); in particular, only two cases (11,12) presented the coexistence of squamous cell carcinoma and breast cancer, similarly to our case, which turns out to be the third case report documented since 1980. As discussed by Pastore et al (12), our patient presented a synchronism of a wide squamous cell carcinoma of the right breast synchronous to a right breast cancer.…”

“…Between 1980 and 2018 only 12 cases of MPMNs involving the breast gland or the skin have been described (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). Among these, only two (11,12) cases report the coexistence of breast and cutaneous squamous cell cancers (Table I).…”

“…Breast cancer patients may develop, with a higher risk with respect to the normal population, secondary malignancies, including leukemia and non-Hodgkin's lymphoma (54). The second tumor is usually metachronous (22, 55-64) and appears 2-5 years following the eventual chemotherapy and radiotherapy (54), while synchronous breast cancer and lympho-proliferative diseases are much rarer (18,37,55,58,60,63,65). Several case reports describe the coexistence between breast cancer and lymphoma more frequently than expected, with no evidence that the second tumor was treatmentinduced (60-65).…”

Coincident of Gastrointestinal Stromal Tumor and Two Other Primary Malignancies: A Case Report

“…After a while, the patient complicated with SCC of the lower lip, leading to 28 courses of radiotherapy, followed by the recurrence of gastrointestinal symptoms; the SCC of the esophagus was also detected accidentally. The management of such patients needs multidisciplinary teams and their discussion because there is no universal protocol for this issue (1,4). Moreover, differentiation between second primary cancer and metastases is very important because of their different management ways; for example, for second primary cancer, surgery can be a good option but for metastatic tumors, systemic chemotherapy is a better option (12).…”

“…Multiple Primary Malignancies (MPMs) include the presence of two or more distinctive primary malignancies, apart from metastases, in a single patient (1,2). Because of the increasing number of cancer survivors, improved screening and diagnostic systems, and increased number of the older population, MPMs also have been on the rise (2,3).…”