Te Mateo, Lumanlan-Mosqueda Donnah Bless, Demegillo Kenny Jun
Department of Internal Medicine, Southern Philippines Medical Center, Davao City, Philippines.
J ASEAN Fed Endocr Soc. 2020;35(2):200-209. doi: 10.15605/jafes.035.02.08. Epub 2020 Oct 20.
Multiple primary tumors are rare, with a published meta-analysis that shows the frequency of second primary tumor at 3-5%, and a third tumor at 0.5%. A 57-year-old female sought consultation due to a persistently bleeding right nasolabial mass. On further history and examination, she also presented with a right anterior neck mass, repeated abortions, secondary amenorrhea, and loss of libido years prior. Serum prolactin was significantly elevated and an incidental finding of a pituitary mass on head and neck CT scan was appreciated. Metastasis and syndromic familial disorder were ruled out. Bromocriptine was given and she underwent total thyroidectomy and wide excision of the right nasolabial mass which turned out to be papillary thyroid carcinoma (PTC) and basal cell carcinoma (BCC) respectively on histopathologic report. On follow up, repeat serum prolactin decreased to normal levels. After extensive literature review, this is the first documented case of triple synchronous tumors with a combination of BCC of the right nasolabial area, PTC and prolactinoma in local, national and international studies. With comprehensive work up and literature search, the diagnosis was established and ultimately the patient benefited from a multidisciplinary management.
多发性原发性肿瘤较为罕见，一项已发表的荟萃分析显示，第二原发性肿瘤的发生率为3% - 5%，第三原发性肿瘤的发生率为0.5%。一名57岁女性因右侧鼻唇肿块持续出血前来咨询。进一步询问病史和检查发现，她多年前还出现过右侧颈部前方肿块、反复流产、继发性闭经和性欲减退。血清催乳素显著升高，头颈部CT扫描偶然发现垂体肿块。排除了转移和综合征性家族性疾病。给予溴隐亭治疗，她接受了全甲状腺切除术和右侧鼻唇肿块广泛切除术，组织病理学报告显示分别为乳头状甲状腺癌（PTC）和基底细胞癌（BCC）。随访时，血清催乳素复查降至正常水平。经过广泛的文献检索，在本地、国内和国际研究中，这是首例记录在案的同时发生的三种肿瘤，包括右侧鼻唇区域基底细胞癌、乳头状甲状腺癌和催乳素瘤。通过全面的检查和文献检索，确诊后患者最终受益于多学科管理。
