Hong Zhao, Tongsong Zhang, Cunhai Chen, Xiao Li, Haiping Song
Department of Gastroenterology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences Qingdao Central Hospital, Qingdao, China.
Department of Radiotherapy, Qilu Hospital of Shandong University (Qingdao), Qingdao, China.
SAGE Open Med Case Rep. 2024 May 27;12:2050313X241252371. doi: 10.1177/2050313X241252371. eCollection 2024.
The occurrence of multiple primary malignancies in a single patient has been relatively rare. We report here the case of a 71-year-old man with three primary tumors of lung cancer, intrahepatic cholangiocarcinoma, and prostate cancer, and a preliminary study of the mechanisms by which multiple primary tumors develop at the genetic level. Because of the late stage of the patient's condition, large tumor burden, and poor physical status, the patient survived only a few months. In the case presented herein, cholangiocarcinoma, lung cancer, and prostate cancer were found simultaneously, and the pathogenic sites are not related. Whole-exome sequencing was performed on the pathological tissues to explore the mechanism that may underlie multiple primary cancers at the genetic level. Several gene mutations were found in this case. They involved cell proliferation, cell cycle regulation, genetic stability, metabolism, cell invasion, angiogenesis, cell apoptosis, and other pathways. It can be preliminarily inferred that the mechanism underlying multiple primary tumors is related to the abnormality of tumor-promoting and suppressing pathways.
一名患者体内出现多种原发性恶性肿瘤的情况相对罕见。我们在此报告一例71岁男性患者,其患有肺癌、肝内胆管癌和前列腺癌三种原发性肿瘤,并对多种原发性肿瘤在基因水平上发生发展的机制进行了初步研究。由于患者病情处于晚期,肿瘤负荷大且身体状况差,患者仅存活了几个月。在本文所述病例中,胆管癌、肺癌和前列腺癌同时被发现,且发病部位不相关。对病理组织进行了全外显子组测序,以探索在基因水平上可能构成多种原发性癌症基础的机制。该病例中发现了几种基因突变。它们涉及细胞增殖、细胞周期调控、遗传稳定性、代谢、细胞侵袭、血管生成、细胞凋亡等途径。可以初步推断,多种原发性肿瘤的潜在机制与肿瘤促进和抑制途径的异常有关。