Li Yan, Ye Lian-Song, Hu Bing
Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
World J Clin Cases. 2021 Nov 16;9(32):9889-9895. doi: 10.12998/wjcc.v9.i32.9889.
Treatment of synchronous multiple primary malignancies is quite often very challenging. Herein, we report on a rare case of synchronous multiple primary malignancies in the esophagus, stomach, and jejunum.
A 50-year-old man who was a heavy drinker and smoker with a poor diet, and had a family history of cancer sought treatment due to dysphagia lasting for 4 mo. He was finally diagnosed with lower esophageal squamous cell carcinoma (pT3N2M0, G2, stage IIIB), gastric angular adenocarcinoma (pT3N2M0, G2-G3, stage IIIA) with greater omental lymph node metastasis, and jejunal stromal tumor (high risk). The high-risk jejunal stromal tumor was found during surgery. In spite of radical resection and adjuvant chemotherapy, lymph node metastasis occurred 21 mo later. The patient responded poorly to additional chemotherapy and refused further examination and therapy. He died of widespread metastases 33 mo after surgery.
This case indicates a poor prognosis of synchronous multiple advanced primary malignancies and the importance of comprehensive assessment in the population at high risk for cancer.
同步性多原发性恶性肿瘤的治疗常常极具挑战性。在此,我们报告一例罕见的食管、胃和空肠同步性多原发性恶性肿瘤病例。
一名50岁男性,有酗酒和吸烟史,饮食不佳,有癌症家族史,因持续4个月的吞咽困难寻求治疗。最终诊断为食管下段鳞状细胞癌(pT3N2M0,G2,ⅢB期)、胃角腺癌(pT3N2M0,G2 - G3,ⅢA期)伴大网膜淋巴结转移以及空肠间质瘤(高危)。高危空肠间质瘤在手术中被发现。尽管进行了根治性切除和辅助化疗,但21个月后发生了淋巴结转移。患者对额外化疗反应不佳,拒绝进一步检查和治疗。术后33个月死于广泛转移。
该病例表明同步性多原发性晚期恶性肿瘤预后不良,以及对癌症高危人群进行综合评估的重要性。