Upadhyay Amitabh, Shekhar Shashank, Pandey Vanita, Prakash Aaditya, Saha Kaushik
Oncology, Tata Main Hospital, Jamshedpur, IND.
Medical Oncology, Meherbai Tata Memorial Hospital, Jamshedpur, IND.
Cureus. 2023 Jul 10;15(7):e41631. doi: 10.7759/cureus.41631. eCollection 2023 Jul.
Synchronous adenocarcinoma of the stomach with lymphoma is extremely rare. We report a case of a 65-year-old male patient with synchronous adenocarcinoma of the stomach with nodal marginal zone lymphoma. Initial endoscopic biopsy suggested invasive moderately differentiated adenocarcinoma and a locoregional disease, per contrast-enhanced computed tomography (CECT) scans. The patient was started on neo-adjuvant chemotherapy with the 5FU, leucovorin, oxaliplatin, docetaxel (FLOT) regime and, after response evaluation, underwent radical gastrectomy. Histopathology and immunohistochemistry suggested synchronous adenocarcinoma of the stomach with marginal zone lymphoma in perigastric lymph nodes. This case is probably the first such synchronous malignancy case reported from India. The prognosis of multiple primary malignancies is usually poor because no standard guidelines are available regarding optimum treatment and sequencing of available treatment modalities. The frequency of synchronous primary cancers has been increasing in recent years, probably due to better diagnostic modalities, and second primary in patients with cancer should be considered as one of the differential diagnoses.
胃同步性腺癌合并淋巴瘤极为罕见。我们报告一例65岁男性患者，患有胃同步性腺癌合并淋巴结边缘区淋巴瘤。最初的内镜活检提示为浸润性中分化腺癌且为局部区域性疾病，根据增强计算机断层扫描（CECT）结果判断。患者开始接受新辅助化疗，采用5-氟尿嘧啶、亚叶酸钙、奥沙利铂、多西他赛（FLOT）方案，在疗效评估后，接受了根治性胃切除术。组织病理学和免疫组织化学提示胃同步性腺癌合并胃周淋巴结边缘区淋巴瘤。该病例可能是印度报道的首例此类同步性恶性肿瘤病例。多种原发性恶性肿瘤的预后通常较差，因为关于最佳治疗及现有治疗方式的顺序安排尚无标准指南。近年来，同步性原发性癌症的发生率一直在上升，这可能归因于更好的诊断方式，并且癌症患者的第二原发性癌症应被视为鉴别诊断之一。
