Lv Xingyu, Ye Jianming, Jiang Guangyi, Wang Yifan, Lv Jisheng, Wang Yong
Department of General Surgery, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University Hangzhou, Zhejiang, China.
Key Laboratory of Laparoscopic Technology of Zhejiang Province, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University Hangzhou, Zhejiang, China.
Int J Clin Exp Pathol. 2020 May 1;13(5):1212-1215. eCollection 2020.
Multiple primary cancers are of rare occurrence. Most multiple primary cancers are metachronous multiple primary cancers, while simultaneous multiple primary cancers are rare. Inflammatory myofibroblastic tumors are rare. Inflammatory myofibroblastic tumor occurs most frequently in children and young adults. Herein, we report a rare case of simultaneous multiple primary cancers and inflammatory myofibroblastic tumor. A 44-year-old woman was admitted for a breast mass evaluation. The patient was positive for antinuclear, anti-mitochondrial, and anti-RO52 antibodies. Breast magnetic resonance imaging revealed a right breast mass. After neoadjuvant chemotherapy, modified radical mastectomy was performed. Postoperative histopathology revealed an invasive ductal carcinoma. Two months later, computed tomography revealed a nodule in the right upper lobe and ground-glass opacity in the lower lobe of the lungs. Lobectomy and lobe biopsy were performed. Postoperative histopathology revealed that the mass in the right upper lobe was an inflammatory myofibroblastic tumor and the right lower lobe lesion was an invasive adenocarcinoma. Immunohistochemistry of the inflammatory myofibroblastic tumor revealed negativity for anaplastic lymphoma kinase. At the 4-month follow-up, the patient showed good recovery. The etiology of multiple primary cancers and inflammatory myofibroblastic tumors is still unknown; in this case, we believe that autoimmune factors are the main cause of multiple primary cancers with concomitant inflammatory myofibroblastic tumor. Tissue biopsy is needed to ensure correct diagnosis of multiple primary cancers and inflammatory myofibroblastic tumor. Surgery-based comprehensive therapy is recommended. The prognosis is favorable and regular follow-up is necessary.
多原发性癌较为罕见。大多数多原发性癌为异时性多原发性癌，而同时性多原发性癌则很罕见。炎性肌纤维母细胞瘤也很罕见。炎性肌纤维母细胞瘤最常发生于儿童和年轻人。在此，我们报告一例罕见的同时性多原发性癌合并炎性肌纤维母细胞瘤的病例。一名44岁女性因乳腺肿块评估入院。该患者抗核抗体、抗线粒体抗体和抗RO52抗体呈阳性。乳腺磁共振成像显示右乳有一肿块。新辅助化疗后，行改良根治性乳房切除术。术后组织病理学检查显示为浸润性导管癌。两个月后，计算机断层扫描显示右上叶有一结节，右下叶有磨玻璃影。行肺叶切除术和肺叶活检。术后组织病理学检查显示右上叶肿块为炎性肌纤维母细胞瘤，右下叶病变为浸润性腺癌。炎性肌纤维母细胞瘤的免疫组织化学检查显示间变性淋巴瘤激酶为阴性。在4个月的随访中，患者恢复良好。多原发性癌和炎性肌纤维母细胞瘤的病因仍不清楚；在本病例中，我们认为自身免疫因素是伴有炎性肌纤维母细胞瘤的多原发性癌的主要原因。需要进行组织活检以确保正确诊断多原发性癌和炎性肌纤维母细胞瘤。建议采用以手术为主的综合治疗。预后良好，需要定期随访。
