Maruyama Tessho, Nakasone Toshiyuki, Maruyama Nobuyuki, Matayoshi Akira, Arasaki Akira
Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan.
Department of Oral and Maxillofacial Surgery, University Hospital of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan.
World J Surg Oncol. 2015 Aug 28;13:263. doi: 10.1186/s12957-015-0684-5.
Reports of synchronous multiple primary cancers in patients with oral cancer have recently been increasing because of progress in radiographic diagnostic techniques. Multiple primary cancers in patients with oral cavity cancer mainly occur in the head and neck region, lung, and esophagus. 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography is usually used to identify synchronous multiple primary cancers.
We herein describe a 69-year-old woman diagnosed with synchronous quadruple multiple primary cancers, namely a squamous cell carcinoma of the mobile tongue, invasive ductal carcinoma of the right breast, intraductal carcinoma of the left breast, and chromophobe renal cell carcinoma of the right kidney. We removed the four tumors over three surgical procedures to reduce the surgical risk because the patient had diabetes mellitus. To the best of our knowledge, this combination of multiple primary cancers has not been reported to date. Importantly, we followed this case for 5 years after surgery. The patient was alive and well with no clinical or radiologic signs of recurrent or metastatic disease at the time of this writing.
In the present case, the kidney cancer could not be detected by 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography but could be detected by contrast-enhanced computed tomography. To avoid overlooking multiple primary cancers of the kidney, we suggest that contrast-enhanced computed tomography should cover a region extending to the inferior margin of the kidney, rather than only to the liver, in patients with oral cavity cancer.
由于放射诊断技术的进步,近期关于口腔癌患者同时发生多种原发性癌症的报道不断增加。口腔癌患者的多种原发性癌症主要发生在头颈部区域、肺部和食管。2-[18F]-氟-2-脱氧-D-葡萄糖正电子发射断层扫描通常用于识别同时发生的多种原发性癌症。
我们在此描述一名69岁女性,被诊断为同时患有四种原发性癌症,即活动期舌鳞状细胞癌、右乳浸润性导管癌、左乳导管内癌和右肾嫌色细胞癌。由于患者患有糖尿病,我们通过三次外科手术切除了这四个肿瘤以降低手术风险。据我们所知,这种多种原发性癌症的组合迄今为止尚未见报道。重要的是,我们在术后对该病例进行了5年的随访。在撰写本文时,患者存活且状况良好,没有复发或转移性疾病的临床或影像学迹象。
在本病例中,2-[18F]-氟-2-脱氧-D-葡萄糖正电子发射断层扫描未能检测到肾癌,但对比增强计算机断层扫描可以检测到。为避免漏诊肾脏的多种原发性癌症,我们建议对于口腔癌患者,对比增强计算机断层扫描应覆盖延伸至肾脏下缘的区域,而不仅仅是肝脏。