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1.
Anticancer Res ; 41(4): 2039-2044, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33813411

RESUMO

BACKGROUND/AIM: The aim of the present study was to assess the value of panendoscopy of the upper aero-digestive tract in the identification of synchronous tumors in OSCC patients without clinical signs of a second primary tumor. PATIENTS AND METHODS: In this retrospective study, patients diagnosed with a primary OSCC who received surgical therapy between January 1st, 2012 and December 31st, 2017 were included. Participants must have undergone panendoscopy during the staging process. None of these patients showed clinical signs of a second primary tumor. RESULTS: A total of 265 patients (99 females and 166 males; mean age=63.3 years, range=26-96 years) were included. The mean (SD) follow-up was 25.88 (±20.479 SD) months. Five synchronous secondary tumors (1.9%) could be identified within this cohort. Of these, only two (0.8%) were located within the area of panendoscopy and were diagnosed in patients with regular alcohol and/or tobacco abuse. Eighteen metachronous second primary tumors were diagnosed, 10 being located within the upper aero-digestive tract. CONCLUSION: The relevance of routinely performed panendoscopy in patients suffering from an oral squamous cell carcinoma without clinical signs of a secondary tumor should be critically re-evaluated, especially in patients without typical risk factors.


Assuntos
Carcinoma de Células Escamosas/diagnóstico , Endoscopia do Sistema Digestório/métodos , Neoplasias Bucais/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Neoplasias Primárias Múltiplas/patologia , Segunda Neoplasia Primária/diagnóstico , Segunda Neoplasia Primária/patologia , Valor Preditivo dos Testes , Estudos Retrospectivos
2.
Medicine (Baltimore) ; 100(14): e24982, 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33832072

RESUMO

RATIONALE: Hypercalcemia is a common finding in patients with advanced-stage cancers. Paraneoplastic hypercalcemia is commonly associated with dismal prognoses, with survival rates of about 3 months. In this paper, we report on a patient with advanced chronic lymphocytic leukemia and non-small cell lung carcinoma who developed severe hypercalcemia and discuss the diagnosis and treatment of this metabolic complication. PATIENT CONCERNS: A 56-year old male with a 2-year history of Rai stage IV chronic lymphocytic leukemia presented with life-threatening hypercalcemia. Positron emission tomography/computed tomography revealed a suspicious lung lesion. A transbronchial biopsy was performed from the upper left lobe. Due to the small size of the specimen, immunohistochemical markers were performed and revealed positive staining for cytokeratin 7 and negative for TTF-1, napsin A and p 40, which were consistent with non-small cell lung carcinoma. DIAGNOSIS: Humoral hypercalcemia of malignancy was diagnosed. INTERVENTION: The patient was treated with saline infusion, calcitonin, intravenous pamidronate, followed with denosumab. OUTCOMES: The hypercalcemia was successfully treated and the patient's calcium levels returned to normal. Further evaluation revealed a non-small cell lung carcinoma as a second primary malignancy. The patient was treated with venetoclax for his refractory CLL and received chemotherapy and immunotherapy for lung adenocarcinoma. Several days after starting venetoclax, he developed Legionella pneumonia and short time after the second course of chemotherapy, a severe sepsis occurred and he passed away. LESSONS: Coexistence of 2 unrelated malignancies, whichever could be a reason for hypercalcemia of malignancy is a rare event. Severe hypercalcemia, which is possible but rare feature of CLL should be a reason for further prompt evaluation.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/induzido quimicamente , Hipercalcemia/etiologia , Leucemia Linfocítica Crônica de Células B/complicações , Carcinoma Pulmonar de Células não Pequenas/complicações , Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Carcinoma Pulmonar de Células não Pequenas/patologia , Evolução Fatal , Humanos , Leucemia Linfocítica Crônica de Células B/tratamento farmacológico , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Segunda Neoplasia Primária/diagnóstico por imagem , Segunda Neoplasia Primária/patologia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons
3.
Medicine (Baltimore) ; 100(10): e24023, 2021 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-33725814

RESUMO

RATIONALE: Fibroadenoma (FA) is a common type of benign breast tumors but ductal carcinoma in situ (DCIS) rarely arises within this tumor type. PATIENT CONCERNS: This case report presents a non-symptomatic 61-year-old woman with FA that was coincidentally found during a breast cancer screening program performed 5 years ago by her city of residence. She had subsequently been followed-up with mammography and breast ultrasound (US). US showed a slightly enlarged tumor and dynamic magnetic resonance imaging (MRI) indicated malignancy within the FA. DIAGNOSIS: The pathological examination revealed low-grade DCIS within the FA. INTERVENTIONS: The patient underwent a core needle biopsy followed by breast-conserving therapy with sentinel lymph node biopsy and then postoperative radiation therapy. OUTCOMES: Currently, she has been followed-up for 2 years without no signs of recurrence. LESSONS: Careful observation with US followed by dynamic MRI is essential in the early diagnosis of DCIS originating in a FA.


Assuntos
Neoplasias da Mama/diagnóstico , Carcinoma Intraductal não Infiltrante/diagnóstico , Fibroadenoma/diagnóstico , Segunda Neoplasia Primária/diagnóstico , Doenças Assintomáticas/terapia , Biópsia por Agulha , Mama/diagnóstico por imagem , Mama/patologia , Mama/cirurgia , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Carcinoma Intraductal não Infiltrante/patologia , Carcinoma Intraductal não Infiltrante/terapia , Feminino , Fibroadenoma/patologia , Fibroadenoma/terapia , Seguimentos , Humanos , Achados Incidentais , Mamografia , Mastectomia Segmentar , Pessoa de Meia-Idade , Segunda Neoplasia Primária/patologia , Segunda Neoplasia Primária/terapia , Radioterapia Adjuvante , Tomografia Computadorizada por Raios X , Resultado do Tratamento
4.
Medicine (Baltimore) ; 100(7): e24806, 2021 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-33607843

RESUMO

RATIONALE: Oral cancer often causes secondary primary cancers in the upper gastrointestinal tract. However, there are no reports of secondary primary cancers in patients with oral squamous cell carcinoma and malignant lymphoma of the small intestine. This report describes a case of metachronous multiple primary cancers of the tongue and small intestine malignant lymphoma. PATIENTS CONCERNS: The patient was admitted to our department with the chief complaint of pain in the right tongue. Partial tongue resection and supraomohyoid neck dissection were performed. One year after surgery, the patient experienced abdominal pain and bloody stools. DIAGNOSIS: Diffuse large B-cell lymphoma (DLBCL) was diagnosed via histological examination. INTERVENTIONS: A terminal ileum resection was performed. Postoperatively, the patient received 6 courses of rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine, and prednisone (R-CHOP). OUTCOMES: Five years after his initial diagnosis, there is no evidence of recurrence, metastasis, or other primary cancer. LESSONS: Oral cancer patients should always be followed up owing to a possibility of malignant tumors in other areas.


Assuntos
Carcinoma de Células Escamosas/complicações , Intestino Delgado/patologia , Linfoma Difuso de Grandes Células B/patologia , Neoplasias da Língua/patologia , Assistência ao Convalescente , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Ciclofosfamida/administração & dosagem , Ciclofosfamida/uso terapêutico , Doxorrubicina/administração & dosagem , Doxorrubicina/uso terapêutico , Humanos , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/cirurgia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias/métodos , Segunda Neoplasia Primária/patologia , Prednisona/administração & dosagem , Prednisona/uso terapêutico , Rituximab/administração & dosagem , Rituximab/uso terapêutico , Resultado do Tratamento , Vincristina/administração & dosagem , Vincristina/uso terapêutico
5.
Medicine (Baltimore) ; 100(3): e24378, 2021 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-33546078

RESUMO

RATIONALE: Primary periampullary duodenal cancer accounts for 3% to 17% of periampullary cancers. There are no previous reports of metachronous primary colon and periampullary duodenal cancer. PATIENT CONCERNS: We present a case of primary periampullary duodenal cancer that occurred metachronously after colon cancer. DIAGNOSES: Imaging and endoscopic examinations, serum tumor marker levels, and pathology confirmed metachronous colon and periampullary duodenal cancer, with 14-month interval between the diagnoses of the 2 malignancies. INTERVENTION: The patient received right hemicolectomy combined with mFOLFOX6 chemotherapy for colon cancer and pancreatoduodenectomy for periampullary duodenal cancer. OUTCOMES: The patient has been followed up for 6 years since the pancreatoduodenectomy and shows no signs of recurrence or metastasis. LESSONS: The risk of developing a second malignancy may be associated with the site of the first tumor. Patients with right colon cancer may have particularly high risk of developing small intestinal cancer, including duodenal cancer. Early detection and active surgical treatments can improve prognosis. Long-term regular follow-up is necessary to detect new malignancies occurring after the diagnosis colon cancer.


Assuntos
Neoplasias Duodenais/patologia , Segunda Neoplasia Primária/patologia , Dor Abdominal/etiologia , Idoso , Antígenos Glicosídicos Associados a Tumores/análise , Antígenos Glicosídicos Associados a Tumores/sangue , Antígeno Carcinoembrionário/análise , Antígeno Carcinoembrionário/sangue , Neoplasias Duodenais/diagnóstico , Humanos , Masculino , Segunda Neoplasia Primária/diagnóstico , Prognóstico , Ultrassonografia/métodos
6.
Kyobu Geka ; 74(1): 22-27, 2021 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-33550315

RESUMO

OBJECTIVES: In order to perform appropriate treatment for metachronous multiple lung cancer, it is important to verify the surgical treatment outcome. We evaluated the surgical outcome of metachronous multiple lung cancer focused on the sublobar resection of metachronous second lung cancer. METHODS: The subjects of this study were 1,513 cases that underwent radical resection for primary lung cancer in our institution from January 2004 to April 2020. We selected 23 (1.5%) patients who underwent lobectomy for initial primary lung cancer and underwent sublobar resection for metachronous second lung cancer. RESULTS: The median follow-up period from resection for initial primary lung cancer to resection for metachronous second lung cancer was 49 months. Regarding the analyses for survival, the median follow-up period after resection for initial primary lung cancer was 79 months with a five-year overall survival rate of 80.4% and a five-year relapse-free survival rate of 75.6%. Whereas the median follow-up period after resection for metachronous second lung cancer was 27 months with a five-year overall survival rate of 55.8% and a five-year relapse-free survival rate was 48.4%. CONCLUSIONS: The long-term outcome for sublobar resection for metachronous second lung cancer was similar to previous reports and the rate of complications tended to be low.


Assuntos
Neoplasias Pulmonares , Segunda Neoplasia Primária , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Segunda Neoplasia Primária/patologia , Segunda Neoplasia Primária/cirurgia , Pneumonectomia , Estudos Retrospectivos
7.
JAMA Netw Open ; 4(1): e2031661, 2021 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-33416884

RESUMO

Importance: Radiotherapy is a common treatment for rectal cancer, yet the risk of second gynecological malignant neoplasms (SGMNs) in patients with rectal cancer undergoing radiotherapy have not been adequately studied. Objective: To investigate the association between radiotherapy and the risk of individual types of SGMN in patients with rectal cancer and assess survival outcomes. Design, Setting, and Participants: A large population-based cohort study was designed to identify the risk of SGMNs in patients with rectal cancer diagnosed from January 1973 to December 2015. The statistical analysis was conducted from September 2019 to April 2020. The study was based on the 9 cancer registries of Surveillance, Epidemiology, and End Results database. A total of 20 142 female patients with rectal cancer in localized and regional stage were included. Exposure: Receipt of neoadjuvant radiotherapy for rectal cancer. Main Outcomes and Measures: The development of an SGMN defined as any type of GMN occurring more than 5 years after the diagnosis of rectal cancer. The cumulative incidence of SGMNs was estimated by Fine-Gray competing risk regression. Poisson regression was used to evaluate the radiotherapy-associated risk for SGMNs in patients undergoing radiotherapy vs patients not undergoing radiotherapy. The Kaplan-Meier method was used to assess the survival outcomes of patients with SGMNs. Results: Of 20 142 patients, 16 802 patients (83.4%) were White and the median age was 65 years (interquartile range, 54-74 years). A total of 5310 (34.3%) patients were treated with surgery and radiotherapy, and 14 832 (65.7%) patients were treated with surgery alone. The cumulative incidence of SGMNs during 30 years of follow-up was 4.53% among patients who received radiotherapy and 1.53% among patients who did not. In competing risk regression analysis, undergoing radiotherapy was associated with a higher risk of developing cancer of the uterine corpus (adjusted hazard ratio, 3.06; 95% CI, 2.14-4.37; P < .001) and ovarian cancer (adjusted hazard ratio, 2.08; 95% CI, 1.22-3.56; P = .007) compared with those who did not receive radiotherapy. The dynamic radiotherapy-associated risks (RR) for cancer of the uterine corpus significantly increased with increasing age at rectal cancer diagnosis (aged 20-49 years: adjusted RR, 0.79; 95% CI, 0.35-1.79; P = .57; aged 50-69 years: adjusted RR, 3.74; 95% CI, 2.63-5.32; P < .001; aged ≥70 years: adjusted RR, 5.13; 95% CI, 2.64-9.97; P < .001) and decreased with increasing latency since rectal cancer diagnosis (60-119 months: adjusted RR, 3.22; 95% CI, 2.12-4.87; P < .001; 120-239 months: adjusted RR, 2.72; 95% CI, 1.75-4.24; P < .001; 240-360 months: adjusted RR, 1.95; 95% CI, 0.67-5.66; P = .22), but the dynamic RR for ovarian cancer increased with increasing latency since rectal cancer diagnosis (60-119 months: adjusted RR, 0.70; 95% CI, 0.26-1.89; P = .48; 120-239 months: adjusted RR, 2.26; 95% CI, 1.09-4.70; P = .03; 240-360 months: adjusted RR, 11.84; 95% CI, 2.18-64.33; P = .004). The 10-year overall survival among patients with radiotherapy-associated cancer of the uterine corpus was significantly lower than that among matched patients with primary cancer of the uterine corpus (21.5% vs 33.6%; P = .01). Conclusions and Relevance: Radiotherapy for rectal cancer was associated with an increased risk of cancer of the uterine corpus and ovarian cancer. Special attention should be paid to reduce radiotherapy-associated SGMNs and improve their prognosis.


Assuntos
Neoplasias dos Genitais Femininos/epidemiologia , Segunda Neoplasia Primária/epidemiologia , Neoplasias Retais/epidemiologia , Neoplasias Retais/radioterapia , Idoso , Estudos de Coortes , Feminino , Seguimentos , Neoplasias dos Genitais Femininos/etiologia , Humanos , Incidência , Pessoa de Meia-Idade , Terapia Neoadjuvante/estatística & dados numéricos , Segunda Neoplasia Primária/etiologia , Segunda Neoplasia Primária/patologia , Neoplasias Retais/patologia , Programa de SEER , Estados Unidos/epidemiologia
8.
AJR Am J Roentgenol ; 216(3): 633-639, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33439044

RESUMO

OBJECTIVE. The purpose of this article was to determine the frequency and outcomes of new suspicious findings on breast MRI after initiation of neoadjuvant therapy. MATERIALS AND METHODS. A retrospective database review identified all breast MRI examinations performed to assess response to neoadjuvant therapy between 2010 and 2018. Cases with new suspicious lesions assessed as BI-RADS 4 or 5 and found after the initiation of neoadjuvant treatment were included. Cases with no pretreatment MRI, cases in which the suspicious lesion was present on the baseline MRI but remained suspicious, and cases with insufficient follow-up were excluded. Radiologic, pathologic, and surgical reports were reviewed. Malignant outcomes were determined by pathologic examination. Benignity was established by pathologic examination, follow-up imaging, or both. A total of 419 breast MRI examinations in 297 women were performed to assess response to neoadjuvant therapy. After exclusions, 23 MRI examinations (5.5%) with new suspicious findings, all assessed as BI-RADS 4, comprised the final cohort. RESULTS. Of the 23 lesions, 13 new suspicious findings (56.5%) were contralateral to the known malignancy, nine (39.1%) were ipsilateral, and one (4.3%) involved the bilateral breasts. Lesion types included mass (16, 69.6%), nonmass enhancement (5, 21.7%) and focus (2, 8.7%). None of the new suspicious findings were malignant. CONCLUSION. New suspicious findings occurred in 5.5% of breast MRI examinations performed to monitor response to neoadjuvant therapy, and none of these new lesions were malignant. Our findings suggest that new lesions that arise in the setting of neoadjuvant therapy are highly unlikely to represent a new site of malignancy, particularly if the index malignancy shows treatment response. Larger studies are needed to confirm whether biopsy may be safely averted in this scenario.


Assuntos
Neoplasias da Mama/terapia , Imagem por Ressonância Magnética/métodos , Terapia Neoadjuvante , Segunda Neoplasia Primária/diagnóstico por imagem , Adulto , Idoso , Mama/patologia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/diagnóstico por imagem , Carcinoma Ductal de Mama/tratamento farmacológico , Carcinoma Ductal de Mama/patologia , Meios de Contraste , Feminino , Humanos , Biópsia Guiada por Imagem/métodos , Imagem por Ressonância Magnética/estatística & dados numéricos , Imagem por Ressonância Magnética Intervencionista/métodos , Pessoa de Meia-Idade , Segunda Neoplasia Primária/patologia , Estudos Retrospectivos , Resultado do Tratamento , Ultrassonografia de Intervenção/métodos
9.
BMJ Case Rep ; 13(12)2020 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-33318271

RESUMO

Sarcomas are a rare and fatal treatment complication following radiotherapy. Radiation-induced sarcomas (RISs) presenting as a gluteal abscess is a rarity, accounting for its varied presentation. We present a case of a middle-aged woman, post-chemo-radiation for carcinoma cervix 5 years ago, who presented with gluteal abscess. Achieving haemostasis post incision and drainage under anaesthesia was a challenge. On further evaluation, she was diagnosed with radiation-induced gluteal soft tissue sarcoma. Haemostasis was achieved after radiation following failed attempts of surgical and radiological interventions. She is currently planned for chemotherapy. Cancer survivors have an increased risk of developing a second malignancy following radiation treatment. RISs are highly aggressive, exhibit a varied clinical presentation and pose a challenge in early diagnosis; thus, have a poor outcome. RISs pose a diagnostic challenge; any dubious lesion in the previously irradiated field should raise suspicion and prompt aggressive management.


Assuntos
Nádegas , Neoplasias Induzidas por Radiação/diagnóstico , Segunda Neoplasia Primária/diagnóstico , Sarcoma/diagnóstico , Abscesso/diagnóstico , Angiografia Digital , Doenças do Ânus/diagnóstico , Biópsia , Nádegas/diagnóstico por imagem , Nádegas/patologia , Carcinoma de Células Escamosas/radioterapia , Angiografia por Tomografia Computadorizada , Diagnóstico Diferencial , Feminino , Hemorragia/etiologia , Hemorragia/terapia , Técnicas Hemostáticas , Humanos , Pessoa de Meia-Idade , Neoplasias Induzidas por Radiação/complicações , Neoplasias Induzidas por Radiação/patologia , Segunda Neoplasia Primária/complicações , Segunda Neoplasia Primária/patologia , Sarcoma/complicações , Sarcoma/diagnóstico por imagem , Sarcoma/patologia , Tomografia Computadorizada por Raios X , Neoplasias do Colo do Útero/radioterapia
10.
Medicine (Baltimore) ; 99(40): e22483, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019442

RESUMO

INTRODUCTION: Epithelial-myoepithelial carcinoma (EMC) is a rare, low-grade malignancy that occurs primarily in the parotid gland and is most common in women aged 60 to 70 years. Cases of parotid EMC have been reported previously. Furthermore, some studies have suggested an increased risk of salivary gland tumors with secondary primary malignancies. There have been few reports of parotid EMC with other primary tumors. PATIENT CONCERNS: A 62-year-old Chinese man visited the hospital with a complaint of a mass on his left cheek that had persisted for 20 years. Routine pulmonary computed tomography showed a local ground glass shadow in the lower lobe of the right lung. DIAGNOSIS: The pathological diagnosis of lung was right lower lobe lung adenocarcinoma (pT1N0). Immunohistochemistry analysis showed that cytokeratin (CK)-7, NapsinA, and thyroid transcription factor-1 tested positive, while CK5/6, P40, and ALKD5F3 tested negative. The pathological diagnosis of left parotid gland: EMC. On immunohistochemistry staining, the outer cells expressed myoepithelial markers, such as CK5/6, P63, smooth muscle actin, while the inner cells expressed glandular epithelial markers, such as low-molecular-weight CK7 and CK8. INTERVENTIONS: The patient underwent resection of the lung and parotid tumors, and received preventive radiotherapy in the parotid gland area. OUTCOMES: The patient is in good condition. No symptom recurrence, distant metastatic spread or significant toxicity occurred during or after the treatment. The patient remains under regular surveillance. CONCLUSION: We report a rare case of parotid EMC with a second primary lung adenocarcinoma. This case is the third case of primary lung cancer associated with parotid EMC reported to date and the first to be reported in nearly 30 years.


Assuntos
Adenocarcinoma de Pulmão/patologia , Neoplasias Pulmonares/patologia , Mioepitelioma/patologia , Segunda Neoplasia Primária/patologia , Neoplasias Parotídeas/patologia , Adenocarcinoma de Pulmão/cirurgia , Humanos , Imuno-Histoquímica , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Mioepitelioma/radioterapia , Mioepitelioma/cirurgia , Segunda Neoplasia Primária/radioterapia , Segunda Neoplasia Primária/cirurgia , Neoplasias Parotídeas/radioterapia , Neoplasias Parotídeas/cirurgia
11.
Anticancer Res ; 40(11): 6485-6492, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33109587

RESUMO

BACKGROUND: We aimed to verify the clinical efficacy and safety of the electrochemotherapy in melanoma metastases and in cases of rare non-melanoma tumors that were difficult to treat for the specific anatomical site or for patient comorbidities. PATIENTS AND METHODS: We treated 68 patients (699 cutaneous nodules), 44 patients with metastatic melanomas and 24 patients with non-melanoma tumors, at the Melanoma & Skin Cancer Unit, Florence, Italy. RESULTS: We obtained an objective response of 89.7% (88.6% in melanomas and 91.7% in non-melanoma tumors), complete response 54.4% and partial response 35.3%. CONCLUSION: This study showed that electrochemotherapy is effective in the treatment of melanoma metastases and in rare types of non-melanoma tumors. In particular, we successfully treated rare tumors as angiosarcoma, pleomorphic sarcoma, myxofibrosarcoma, sarcoma di Kaposi, porocarcinoma, sebaceous carcinoma, Merkel cell carcinoma, malignant blue nevus, undifferentiated epitheliomorphic cell neoplasia and metastases from thyroid carcinoma. No serious adverse events were observed.


Assuntos
Eletroquimioterapia , Melanoma/terapia , Segunda Neoplasia Primária/terapia , Neoplasias Cutâneas/terapia , Adulto , Bleomicina/administração & dosagem , Carcinoma de Célula de Merkel , Feminino , Humanos , Itália/epidemiologia , Masculino , Melanoma/patologia , Pessoa de Meia-Idade , Segunda Neoplasia Primária/patologia , Indução de Remissão , Neoplasias Cutâneas/patologia , Resultado do Tratamento
12.
PLoS One ; 15(8): e0231807, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32756555

RESUMO

BACKGROUND: Lung cancer is increasingly common as a second primary malignancy. However, the clinical characteristics of second primary non-small cell lung cancer after cervical cancer (CC-NSCLC) compared with first primary non-small cell lung cancer (NSCLC1) is unknown. METHODS: The Surveillance, Epidemiology, and End Results (SEER) cancer registry between 1998 and 2010 was used to conduct a large population-based cohort analysis. The demographic and clinical characteristics, as well as prognostic data, were systematically analyzed. The overall survival (OS) in the two cohorts was further compared. The risk factors of second primary lung cancer in patients with cervical cancer were also analyzed. RESULTS: A total of 557 patients (3.52%) developed second primary lung cancer after cervical cancer, and 451 were eligible for inclusion in the final analyses. Compared with NSCLC1, patients with CC-NSCLC had a higher rate of squamous cell carcinoma (SCC) (36.59% vs 19.07%, P < 0.01). The median OS was longer for CC-NSCLC than for NSCLC1 before propensity score matching (PSM) (16 months vs. 13 months) but with no significant difference after PSM (16 months vs. 17 months). The high-risk factors for the development of cervical cancer to CC-NSCLC include age 50-79 years, black race [odds ratio (OR) 1.417; 95% confidence interval (CI) 1.095-1.834; P < 0.05], and history of radiotherapy (OR 1.392; 95% CI 1.053-1.841; P < 0.05). CONCLUSION: Age 50-79 years, black race, and history of radiotherapy were independent risk factors for second primary lung cancer in patients with cervical cancer. Patients with CC-NSCLC had distinctive clinical characteristics and better prognosis compared with patients with NSCLC1.


Assuntos
Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/patologia , Segunda Neoplasia Primária/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma de Células Escamosas , Feminino , Humanos , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Pontuação de Propensão , Fatores de Risco , Programa de SEER , Análise de Sobrevida , Neoplasias do Colo do Útero/complicações
13.
Medicine (Baltimore) ; 99(30): e21328, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791729

RESUMO

The purpose of this study was to report the clinicopathological characteristics and treatment outcomes of 45 rectal cancer patients who have a history of cervical cancer with or without remote radiotherapy. Twenty-nine patients (64.4%) with a history of cervical cancer treated with pelvic radiotherapy were classified as group A, 16 (35.6%) patients with a history of cervical cancer not treated with radiotherapy were classified as group B. The median duration between radiotherapy for cervical cancer and rectal adenocarcinoma diagnosis was 18 years. At the time of rectal cancer diagnosis, 5 (17.2%) patients presented stage I disease, 15 (51.7%) had stage II, 1 (3.4%) had stage III, and 8 (27.6%) had stage IV. The patients in group A had older age, higher rates of gross ulcerative lesions, low hemoglobin levels, and a lower rate of lymph node metastases. The patients with secondary rectal cancer developed after radiotherapy for cervical cancer usually presented with abnormal abdominal symptoms, such as proctitis, cystitis, or rectal fistula. Higher colostomy rate was found in this group of patients due to severe pelvic fibrosis or proctitis.


Assuntos
Segunda Neoplasia Primária/patologia , Radioterapia/efeitos adversos , Neoplasias Retais/patologia , Neoplasias do Colo do Útero/patologia , Adenocarcinoma/secundário , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Colostomia/estatística & dados numéricos , Cistite/epidemiologia , Cistite/etiologia , Feminino , Humanos , Metástase Linfática/patologia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Induzidas por Radiação/epidemiologia , Segunda Neoplasia Primária/epidemiologia , Proctite/epidemiologia , Proctite/etiologia , Prognóstico , Fístula Retal/epidemiologia , Fístula Retal/etiologia , Neoplasias Retais/mortalidade , Estudos Retrospectivos , Taiwan/epidemiologia , Resultado do Tratamento , Neoplasias do Colo do Útero/mortalidade , Neoplasias do Colo do Útero/radioterapia
14.
Yonsei Med J ; 61(7): 579-586, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32608201

RESUMO

PURPOSE: The impact of changes in body mass index and waist circumference on the development of metachronous colorectal neoplasia (CRN) after polypectomy has rarely been examined. We evaluated the association between changes in overall/abdominal obesity and metachronous CRN risk. MATERIALS AND METHODS: We studied patients who underwent ≥1 adenoma removal and surveillance colonoscopy. Patients were classified into the following four groups based on the changes in overall obesity from index to follow-up colonoscopy: non-obesity persisted (group 1), obesity to non-obesity (group 2), non-obesity to obesity (group 3), and obesity persisted (group 4). Patients were also divided into another four groups based on similar changes in abdominal obesity (groups 5-8). RESULTS: The number of patients in groups 1, 2, 3, and 4 was 5074, 457, 643, and 3538, respectively, and that in groups 5, 6, 7, and 8 was 4229, 538, 656, and 2189, respectively. Group 4 had a significantly higher risk of metachronous CRN compared to groups 1 and 2. However, metachronous advanced CRN (ACRN) risk was not different among groups 1, 2, 3, and 4. Metachronous CRN risk in group 8 (abdominal obesity persisted) was higher than that in groups 5 (non-abdominal obesity persisted) and 7 (non-abdominal obesity to abdominal obesity), and tended to be higher than that in group 6 (abdominal obesity to non-abdominal obesity). Additionally, group 8 had a significantly higher risk of metachronous ACRN compared to groups 5, 6, and 7. CONCLUSION: Changes in obesity affected the metachronous CRN risk. In particular, changes in abdominal obesity affected the metachronous ACRN risk.


Assuntos
Pólipos do Colo/cirurgia , Colonoscopia/métodos , Neoplasias Colorretais/patologia , Segunda Neoplasia Primária/patologia , Obesidade Abdominal/complicações , Obesidade/complicações , Adulto , Índice de Massa Corporal , Pólipos do Colo/epidemiologia , Pólipos do Colo/patologia , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/etiologia , Neoplasias Colorretais/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Segunda Neoplasia Primária/epidemiologia , Segunda Neoplasia Primária/etiologia , Segunda Neoplasia Primária/cirurgia , Obesidade/epidemiologia , Obesidade Abdominal/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Circunferência da Cintura/fisiologia
15.
Anticancer Res ; 40(7): 3811-3818, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620620

RESUMO

BACKGROUND/AIM: The objective of this study was to determine the molecular and clinicopathological features, as well as the prognosis of patients with endometrial cancer (EC) having prior malignancy (second primary EC: SPEC) compared with those without a history of prior malignancy (first primary EC: FPEC). MATERIALS AND METHODS: We enrolled 294 FPEC patients and 32 SPEC patients who had undergone surgical resection with curative intent. EC was divided into four groups according to Cancer Genome Atlas Research Network (TCGA) classification. RESULTS: SPEC patients having greater than a 10-year interval from prior malignancy had risk factors including type II histology, deeper myometrial invasion, cervical invasion, and copy number high (CNH) phenotype compared with patients having less than a 10-year interval (p=0.007, p=0.002, p=0.015 and p=0.001). CONCLUSION: SPEC patients having greater than a 10-year interval from prior malignancy possessed numerous high-risk factors for EC.


Assuntos
Neoplasias do Endométrio/genética , Neoplasias do Endométrio/patologia , Segunda Neoplasia Primária/genética , Segunda Neoplasia Primária/patologia , Idoso , Neoplasias do Endométrio/metabolismo , Neoplasias do Endométrio/cirurgia , Feminino , Estudo de Associação Genômica Ampla , Humanos , Imuno-Histoquímica , Segunda Neoplasia Primária/metabolismo , Segunda Neoplasia Primária/cirurgia , Prognóstico
16.
Acta Cytol ; 64(6): 520-531, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32526741

RESUMO

BACKGROUND: Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumour in paediatric population, accounting for 16% of all cases. Patients affected by a previous solid or leukaemic neoplasm during their childhood may develop a second different tumour during the follow-up. In this setting, salivary gland MEC is relatively frequent, accounting for 6% of the second neoplasms in paediatric patients. Consequently, the occurrence of salivary gland nodules in paediatric patients with a previous neoplasm should be considered an event with a high risk of malignancy that poses peculiar diagnostic challenges. SUMMARY: This study was designed to define clinical and instrumental findings and morphological features of MEC on fine-needle aspiration cytology (FNAC) samples in paediatric patients with and without a previous neoplasm. Five patients under 19 years are included in this series. FNAC was performed in all patients on a parotid nodule. We have identified 2 groups of patients: (a) 2 cases with previous history of malignancy (acute lymphoblastic leukaemia and Hodgkin lymphoma) and (b) 3 cases without previous malignant neoplasms. In all cases, a final diagnosis of MEC was rendered. Key Messages: MEC may occur as a second malignancy in paediatric patients. FNAC is certainly a valid and accurate diagnostic tool for this type of neoplasm, even in the paediatric age, allowing the correct management of the patients.


Assuntos
Biópsia por Agulha Fina , Carcinoma Mucoepidermoide/patologia , Segunda Neoplasia Primária/patologia , Neoplasias das Glândulas Salivares/patologia , Adenoma Pleomorfo/patologia , Adolescente , Biópsia por Agulha Fina/métodos , Criança , Feminino , Humanos , Masculino , Neoplasias Parotídeas/patologia , Glândulas Salivares/patologia
17.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 47(2): 61-64, abr.-jun. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-191316

RESUMO

Las neoplasias hematológicas secundarias representan una complicación grave del tratamiento oncológico, aunque se desconoce su incidencia real en las pacientes con tumores ginecológicos. El diagnóstico de la leucemia mieloide aguda secundaria a platinos se basa en la sospecha clínica, las alteraciones morfológicas y el estudio citogenético. A pesar de la quimioterapia paliativa y el trasplante alogénico, que está limitado a ciertos casos, su pronóstico es desfavorable. Por ello deben optimizarse las pautas terapéuticas en los tumores ginecológicos con posibilidad de obtener largas supervivencias y mantener a los pacientes en programas de seguimiento prolongado


Secondary haematological malignancies represent severe complication of cancer treatment, although their real incidence is unknown in gynaecological tumours. The usual presentation of an acute leukaemia associated with platinum is based on clinical and cytogenetic features. Diagnosis is based on clinical suspicion, morphological alterations and cytogenetic studies. Conventional chemotherapy is mainly palliative, whereas allogenic transplantation allows the cure but just a small percentage of cases, so prognosis is dismal. Thus, potential curative therapies for solid tumours should be optimized and patients maintained in long-term surveillance programs


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Leucemia Mieloide Aguda/diagnóstico , Leucemia Mieloide Aguda/tratamento farmacológico , Neoplasias Uterinas/diagnóstico , Segunda Neoplasia Primária/terapia , Neoplasias Uterinas/tratamento farmacológico , Segunda Neoplasia Primária/patologia , Progressão da Doença , Biópsia , Transfusão de Plaquetas , Imuno-Histoquímica
19.
Medicine (Baltimore) ; 99(19): e19962, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32384445

RESUMO

INTRODUCTION: After tyrosine kinase inhibitors (TKIs) targeting BCR-ABL1 were introduced for the treatment of chronic myeloid leukemia, clinical outcomes have improved dramatically. However, together with the increase in the survival rate, a more frequent occurrence of secondary malignancies has been observed as well. TKIs have been demonstrated to be a risk factor of malignancies such as non-Hodgkin lymphoma, prostate cancer, and skin cancer. However, lymphoplasmacytic lymphoma (LPL) has never been reported as a secondary malignancy after TKI treatment in chronic myeloid leukemia (CML). PATIENT CONCERNS: An 81-year-old male patient diagnosed with CML and treated with TKIs for a long period (15 years) was admitted due to a chief complaint of abdominal pain. A large abdominal mass was detected by imaging that included computed tomography. DIAGNOSIS: LPL was confirmed from biopsies after ultrasonography and sigmoidoscopy. Serum IgM level was increased and M protein and monoclonal gammopathy, IgM_kappa light chain type were detected. INTERVENTIONS: The patient received six cycles of R-CHOP chemotherapy. OUTCOMES: After chemotherapy, he showed response. The sizes of the abdominal mass and lymph nodes decreased; moreover, serum M protein and IgM levels decreased, as well. CONCLUSION: Herein, for the first time, we describe a patient who developed LPL as a secondary malignancy after administration of TKIs for the treatment of CML. Our observations indicate the importance of awareness of this secondary malignancy that can develop in CML patients treated with TKIs.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Proteínas de Fusão bcr-abl/antagonistas & inibidores , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Segunda Neoplasia Primária , Macroglobulinemia de Waldenstrom , Idoso de 80 Anos ou mais , Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Biópsia/métodos , Ciclofosfamida/administração & dosagem , Doxorrubicina/administração & dosagem , Humanos , Imunoglobulina M/sangue , Masculino , Segunda Neoplasia Primária/sangue , Segunda Neoplasia Primária/tratamento farmacológico , Segunda Neoplasia Primária/etiologia , Segunda Neoplasia Primária/patologia , Prednisona/administração & dosagem , Radiografia Abdominal/métodos , Rituximab/administração & dosagem , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Vincristina/administração & dosagem , Macroglobulinemia de Waldenstrom/sangue , Macroglobulinemia de Waldenstrom/tratamento farmacológico , Macroglobulinemia de Waldenstrom/etiologia , Macroglobulinemia de Waldenstrom/patologia
20.
Int J Clin Oncol ; 25(9): 1644-1652, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32430733

RESUMO

BACKGROUND: Risk factors for metachronous colorectal cancer (mCRC) in Lynch Syndrome (LS) patients are essential for colorectal cancer (CRC) treatment strategy to perform not only a curative but also preventive surgery. The aim of this study was to evaluate the risk factors for mCRC development in LS patients to define the patient subset that may benefit an extended curative and preventive surgical resection. METHODS: Patient's clinical history, oncological, molecular and follow-up were collected retrospectively from the Hereditary Digestive Tumors Registry at the National Cancer Institute of Milan. The age-related cumulative risk of mCRC was calculated using the Kaplan-Meier method. Factors significantly associated with mCRC were analyzed with a Cox regression model. Overall and specific competitive risks were also calculated. RESULTS: In a total of 1346 CRC patients, 159 (11.8%) developed a mCRC after a mean follow-up of 138 months from the primary tumor. The independent risk factors reported by a multivariate analysis were: pathogenetic variants in MLH1 and MSH2 (HR 2.96 and 1.91, respectively) and history of colorectal adenomas (HR 1.54); whereas female sex and extended surgery were protective (HR 0.59 and 0.79, respectively). CONCLUSIONS: Among a high-risk population for CRC, in particular LS, an extended surgery may be considered in CRC patients with specific risk factors (MLH1 or MSH2 germline pathogenic variants, history of colorectal adenomas) to reduce the risk of mCRC development.


Assuntos
Neoplasias Colorretais Hereditárias sem Polipose/patologia , Neoplasias Colorretais/patologia , Neoplasias Colorretais/cirurgia , Segunda Neoplasia Primária/patologia , Adulto , Idoso , Neoplasias Colorretais/genética , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais Hereditárias sem Polipose/genética , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Proteína 1 Homóloga a MutL/genética , Proteína 2 Homóloga a MutS/genética , Segunda Neoplasia Primária/genética , Segunda Neoplasia Primária/mortalidade , Sistema de Registros , Estudos Retrospectivos , Fatores de Risco
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