Heterochronic triple primary malignancies with Epstein-Barr virus infection and tumor protein 53gene mutation: A case report and review of literature

Abstract

BACKGROUND The diagnosis and etiology of multiple primary malignant neoplasms (MPMNs) are difficult to establish. Here, we report a case of heterochronic triple primary malignancies with gastric cancer, nasopharyngeal squamous cell cancer, and then rectal cancer. CASE SUMMARY The patient was first diagnosed with gastric cancer at the age of 33 in 2014 and underwent distal gastrectomy and gastrojejunostomy and six cycles of adjuvant chemotherapy. Three years later, he was diagnosed with nasopharyngeal cancer and treated with radical chemoradiotherapy in 2017. Recently, a mass in the middle of the rectum was resected and reported as ulcerative, moderately to poorly differentiated adenocarcinoma. Research on the etiology of MPMNs showed that Epstein-Barr virus (EBV) infection may be the cause of gastric cancer and nasopharyngeal squamous cell cancer since these two primary lesions were positive for transcripts of EBV-encoded ribonucleic acid using an in situ hybridization EBV-encoded ribonucleic acid probe in formalin-fixed, paraffin-embedded tissue. The cause of rectal cancer may be due to a somatic mutation of tumor protein 53 gene in exon 8 (c.844C>T, p.Arg282Trp) through high-throughput sequencing for the rectal cancer. Appropriate standard therapy for each primary cancer was administered, and the patient has no evidence of cancer disease to date. CONCLUSION To our knowledge, this is the first report on heterochronic triple primary malignancies whose cause may be associated with EBV infection and tumor protein 53 genetic mutations. The etiological research may not only elucidate the cause of MPMN but also has implications in clinical management.

High-grade serous papillary ovarian carcinoma combined with nonkeratinizing squamous cell carcinoma of the cervix: a case report

“…This concept was first described in 1989. ( 4 – 6 ) MPMN is rare in clinical practice, accounting for only 0.52–11.7% of all malignant neoplasms ( 7 ). Based on the time interval between the occurrence of different primary tumors, MPMN can be further classified into (1) synchronous: relatively rare cases in which the intervals between the occurrences of MPMN are < 6 months, and (2) metachronous: common cases in which the intervals between the occurrences of MPMN are ≥ 6 months, ( 8 ) accounting for approximately 90% of MPMN cases.…”

Triple primario oncológico y su impacto en el dolor

“…Del 60 al 90% de esta población refiere que el dolor interfiere en su funcionalidad, estado de ánimo y sueño, afectando su calidad de vida [3]. Las neoplasias malignas primarias múltiples (NMPM) son clínicamente raras y comprenden entre el 0.52% al 11.7% de todos los cánceres cuyo aumento puede deberse a la mejora en las técnicas de diagnóstico y tratamiento de pacientes con cáncer [4,5].…”