Multiple primary malignancies: sequential development of Ewing sarcoma and carcinoid tumor in a single patient.

IF 1.7 Q2 MEDICINE, GENERAL & INTERNAL
Annals of Medicine and Surgery Pub Date : 2024-09-11 eCollection Date: 2024-10-01 DOI:10.1097/MS9.0000000000002561
Huzafa Ali, Dipendra Adhikari, Azka Noor, Husnain Abbas, Huzaifa Saqib, Ayesha Siddiqa, Amna Khan, Nayab Naeem
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Abstract

Introduction and importance: Multiple primary malignancies (MPMs) involve two or more distinct primary cancers in one individual, either simultaneously or at different times. The incidence of MPMs is rising due to advancements in cancer detection, improved survival rates, and long-term treatment effects. This case report, likely the first of its kind, highlights a rare instance of a 30-year-old female developing a carcinoid tumor 5 years after Ewing sarcoma, emphasizing the need for vigilant monitoring of cancer survivors.

Case presentation: A 30-year-old female with a history of Ewing Sarcoma diagnosed 5 years prior, initially presenting with a vascular, hard mass on her right shoulder, underwent neoadjuvant chemotherapy and surgical excision. She recently presented with high-grade fever, cough, weight loss, and severe chest pain. Imaging and biopsy confirmed a high-grade carcinoid tumor. Histopathology showed positive markers for Synaptophysin, CD56, and Chromogranin, with a Ki-67 index of 30-40%. The patient passed away after one cycle of chemotherapy.

Clinical discussion: Diagnosing and managing MPMs is challenging due to the complexity of distinguishing primary tumors from metastases. This case fits the Warren and Gates' criteria for MPMs. This case confirmed Ewing sarcoma and atypical carcinoid tumor as distinct primary malignancies. Delayed diagnosis worsens outcomes, especially for aggressive atypical carcinoids. This case underscores the importance of thorough diagnostics, long-term follow-up, and improved healthcare infrastructure.

Conclusion: This case report emphasizes the importance of a multidisciplinary approach, regular follow-ups, and timely detection for effective management of MPMs.

多种原发性恶性肿瘤:一名患者相继罹患尤文肉瘤和类癌。
导言和重要性:多原发恶性肿瘤(MPM)是指一个人同时或在不同时间患上两种或两种以上不同的原发癌症。由于癌症检测技术的进步、生存率的提高以及长期治疗效果的改善,多原发性恶性肿瘤的发病率正在上升。本病例报告很可能是首例此类病例报告,重点介绍了一名 30 岁女性在患尤文肉瘤 5 年后又患类癌的罕见病例,强调了对癌症幸存者进行警惕性监测的必要性:一名 30 岁女性,5 年前确诊为尤文肉瘤,最初表现为右肩血管性硬肿块,接受了新辅助化疗和手术切除。她最近出现高烧、咳嗽、体重减轻和剧烈胸痛。影像学检查和活组织检查证实她患有高级别类癌。组织病理学显示,突触素、CD56和色粒素标记阳性,Ki-67指数为30-40%。患者在一个化疗周期后去世:临床讨论:由于区分原发肿瘤和转移瘤的复杂性,诊断和治疗 MPM 具有挑战性。本病例符合沃伦和盖茨的 MPM 标准。该病例证实尤文肉瘤和非典型类癌是不同的原发性恶性肿瘤。延迟诊断会恶化预后,尤其是侵袭性非典型类癌。本病例强调了彻底诊断、长期随访和改善医疗基础设施的重要性:本病例报告强调了多学科方法、定期随访和及时发现对于有效管理类癌的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Medicine and Surgery
Annals of Medicine and Surgery MEDICINE, GENERAL & INTERNAL-
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5.90%
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