Ali Huzafa, Adhikari Dipendra, Noor Azka, Abbas Husnain, Saqib Huzaifa, Siddiqa Ayesha, Khan Amna, Naeem Nayab
CMH Multan Institute of Medical Sciences.
Tuberculosis Treatment Center, Pokhara, Nepal.
Ann Med Surg (Lond). 2024 Sep 11;86(10):6322-6325. doi: 10.1097/MS9.0000000000002561. eCollection 2024 Oct.
Multiple primary malignancies (MPMs) involve two or more distinct primary cancers in one individual, either simultaneously or at different times. The incidence of MPMs is rising due to advancements in cancer detection, improved survival rates, and long-term treatment effects. This case report, likely the first of its kind, highlights a rare instance of a 30-year-old female developing a carcinoid tumor 5 years after Ewing sarcoma, emphasizing the need for vigilant monitoring of cancer survivors.
A 30-year-old female with a history of Ewing Sarcoma diagnosed 5 years prior, initially presenting with a vascular, hard mass on her right shoulder, underwent neoadjuvant chemotherapy and surgical excision. She recently presented with high-grade fever, cough, weight loss, and severe chest pain. Imaging and biopsy confirmed a high-grade carcinoid tumor. Histopathology showed positive markers for Synaptophysin, CD56, and Chromogranin, with a Ki-67 index of 30-40%. The patient passed away after one cycle of chemotherapy.
Diagnosing and managing MPMs is challenging due to the complexity of distinguishing primary tumors from metastases. This case fits the Warren and Gates' criteria for MPMs. This case confirmed Ewing sarcoma and atypical carcinoid tumor as distinct primary malignancies. Delayed diagnosis worsens outcomes, especially for aggressive atypical carcinoids. This case underscores the importance of thorough diagnostics, long-term follow-up, and improved healthcare infrastructure.
This case report emphasizes the importance of a multidisciplinary approach, regular follow-ups, and timely detection for effective management of MPMs.
多发性原发性恶性肿瘤（MPMs）是指一个个体同时或在不同时间发生的两种或更多种不同的原发性癌症。由于癌症检测技术的进步、生存率的提高以及长期治疗效果，MPMs的发病率正在上升。本病例报告可能是首例此类报告，突出了一名30岁女性在尤因肉瘤5年后发生类癌肿瘤的罕见病例，强调了对癌症幸存者进行密切监测的必要性。
一名30岁女性，5年前被诊断为尤因肉瘤，最初表现为右肩部有一个血管性硬块，接受了新辅助化疗和手术切除。她最近出现高热、咳嗽、体重减轻和严重胸痛。影像学检查和活检证实为高级别类癌肿瘤。组织病理学显示突触素、CD56和嗜铬粒蛋白标记物呈阳性，Ki-67指数为30-40%。该患者在一个化疗周期后去世。
由于区分原发性肿瘤和转移瘤的复杂性，诊断和管理MPMs具有挑战性。本病例符合沃伦和盖茨关于MPMs的标准。该病例证实尤因肉瘤和非典型类癌肿瘤为不同的原发性恶性肿瘤。延迟诊断会使预后恶化，尤其是对于侵袭性非典型类癌。本病例强调了全面诊断、长期随访和改善医疗基础设施的重要性。
本病例报告强调了多学科方法、定期随访和及时检测对于有效管理MPMs的重要性。
