Synchronous nasopharyngeal carcinoma and cardia adenocarcinoma accompanied with suspected dermatomyositis: A case report and literature review

Abstract

Abstract. Synchronous multiple primary cancers are relatively uncommon and synchronous multiple cancers in coexistence with dermatomyositis (DM) are extremely rare. In the present study, we report a case of a 64-year-old male with nasopharyngeal undifferentiated non-keratinizing carcinoma and cardia adenocarcinoma which were diagnosed synchronously. In addition, suspected DM was diagnosed during the course of chemotherapy. The symptoms of DM were exaggerated even when methylprednisolone while administered. The patient succumbed to nutritional deterioration four months following his initial admission. In the present study, the etiologies of multiple primary cancers are discussed and a brief review of the literature on the correlation between malignance and DM was conducted. IntroductionMultiple primary cancers are relatively uncommon. The present study reports a case in which synchronous nasopharyngeal undifferentiated non-keratinizing carcinoma and cardia adenocarcinoma were diagnosed. During the therapy course, progressive painless symmetric proximal muscle weakness and a skin rash emerged and were accompanied with dysphasia. In addition, suspected dermatomyositis (DM) was diagnosed. DM developed progressively in spite of application of methylprednisolone until the patient succumbed to nutritional deterioration on May 6, 2012. We present this case with two noteworthy aspects. Firstly, synchronous nasopharyngeal undifferentiated non-keratinizing carcinoma and cardia adenocarcinoma are relatively uncommon; and secondly the coexistance of multiple primary cancers with DM is extremely rare and indicative of poor prognosis. Case reportsClinical presentation. The patient was a 64-year-old male from Sichuan, China. Prior to admittance in January 2012, the patient had experienced tinnitus of the right ear for one year and bloody nasal mucus for two months. A tumor was identified on the right and top wall of the nasopharynx by magnetic resonance imaging (MRI) and nasopharyngeal mirror. MRI also revealed that the right pharynx was absent and the right base of the skull had been destroyed by the tumor. Pathological results of the tumor confirmed that it was nasopharyngeal undifferentiated non-keratinizing carcinoma. Two hard lymph nodes in the right neck, with an approximate diameter of 2 cm, were identified by physical examination. Comprehensive examination of the patient was performed. Abdominal computer tomography (CT) revealed multiple nodules in the liver, indicative of metastasized lesions. The diameter of these nodules ranged between 2 and 3 cm. In addition, CT revealed a thicker than normal cardia tube wall. Gastroscopy was performed and a large neoplasm was identified surrounding almost the entire diameter of the cardia (Fig. 1). Pathological analyses were consistent with the diagnosis of cardia adenocarcinoma. In situ Epstein-Barr virus (EBV)-encoded small RNA (EBER) detection demonstrated that the nasopharyngeal carcinoma cells were positive and cardia carcinoma cells were negative for EBER (Fig. 2). The study ...

Simultaneous resection of an adenocarcinoma of the cardia and a synchronous adenocarcinoma of the sigmoid: Report of a case

“…The present case supports the assumption that synchronous, individually resectable intra-abdominal tumors can be successfully, simultaneously resected through the same surgical approach, as already suggested by previous reports [ [1] , [2] , [3] , 5 ]. The association of a carcinoma of the cardia with other intraabdominal tumors, both individually resectable, is fairly infrequent, but has already been reported [ 2 , 3 , 5 ]. Essential issues arising from such association include the opportunity of performing a neo-adjuvant treatment before surgery, staging operations and the optimal technical choices in case of simultaneous surgical treatment.…”

“…The association of a carcinoma of the cardia with other intraabdominal tumors, both individually resectable, is fairly infrequent, but has already been reported [2,3,5]. Essential issues arising from such association include the opportunity of performing a neo-adjuvant treatment before surgery, staging operations and the optimal technical choices in case of simultaneous surgical treatment.…”

“…The association of intrabdominal neoplasms, either expected or unexpected, when performing abdominal operations for other diseases is not uncommon [ 1 ]. The association of a resectable adenocarcinoma of the cardia with another abdominal, equally resectable, cancer is fairly uncommon [ 2 , 3 ]. We report the case of an adenocarcinoma of the cardia, Siewert stage II, simultaneously resected with a synchronous adenocarcinoma of the sigmoid, and briefly discuss the main issues related to the treatment of this uncommon association.…”

A Novel Nomogram to predict survival of patients with choroidal melanoma

“…Multiple primary cancers are relatively uncommon [18], and whether patients with UM are more likely to have multiple primary cancers remains controversial [19,20]. In our study, we discovered that choroidal melanoma patients with multiple primary cancers are a protective factor for the rst time.…”