Hamada Y, Takise A, Uno D, Itoh H, Ichikawa H, Morishta Y
Department of Surgery, Maebashi Red Cross Hospital, Japan.
Kyobu Geka. 2000 Feb;53(2):101-5.
A 62-year-old man with synchronous multiple primary cancers involving the lung, stomach, and thyroid was admitted. Initially the patient's chest X-ray showed an abnormal shadow in the right middle-lobe indicating lung cancer. During preoperative examination, gastric cancer of the antrum and angle were detected. Excisional biopsy of the lymph node in the neck after chest surgery revealed thyroid cancer. A middle lobectomy with mediastinal lymph node dissection was performed for lung cancer and the histological diagnosis was moderately differentiated adenocarcinoma, pT4N2M0, stage IIIB. Gastric cancer was treated by endoscopic mucosal resection. Considering the relatively better prognosis of papillary thyroid cancer, we concluded that no further treatment to the thyroid lesion was necessary. In Japan, according to autopsy reports, triple primary cancers are gradually increasing. During the periods 1994 to 1996, the incidence of triple cancers was 0.81% of all autopsy cases reported.
一名62岁男性因同时患有涉及肺、胃和甲状腺的多原发性癌症入院。最初,患者的胸部X光显示右中叶有异常阴影,提示肺癌。术前检查期间,发现胃窦和胃角部患有胃癌。胸部手术后颈部淋巴结切除活检显示为甲状腺癌。对肺癌进行了右中叶切除及纵隔淋巴结清扫,组织学诊断为中分化腺癌,pT4N2M0,ⅢB期。胃癌采用内镜黏膜切除术治疗。考虑到乳头状甲状腺癌的预后相对较好,我们得出结论,无需对甲状腺病变进行进一步治疗。在日本,根据尸检报告,三重原发性癌症的病例正在逐渐增加。在1994年至1996年期间,三重癌症的发病率占所有报告尸检病例的0.81%。