Primary multiple tumor with affection of the thyroid gland, uterus, urinary bladder, mammary gland and other organs

Abstract

a b s t r a c tBackground: Nowadays multiple primary tumor is characterized by growth and development of two or more tumors in one patient. The total world sickness rate ranges from 1% to 37%. The presence of four or more tumors in one patient is rare case and presented as casuistry. Case presentation: We showed a case of multiple primary tumor with metahronic lesion of the thyroid, uterus and breast, followed by synchronous benign tumors of the subcutaneous fat, urinary bladder and gallbladder were considered. The development of all malignant tumors in all cases was accompanied by the presence of benign precancerous processes. Analysis of neoplasia histology shows the predominance of poorly differentiated forms of cancers in women with increased aggressiveness of cancerous tissue in each subsequent case and the growth of metastatic ability. The influence of heredity on the tumors progress is confirmed by immunohistochemical characteristics of cancer cells. Steroid-sensitive tissue of the uterus and breast in both cases didn't express ER and PR, in all cases the tissue had overexpression of Ki-67, p53, bax and bcl-2 receptors. The results of DNA testing for determination the Lynch syndrome revealed the presence of microsatellite instability in genetic material. The results of studies revealed the absence of mutations in these genes (MLH1, MSH2 and MSH6). Despite the negative results of the study, it doesn't exclude the possibility of Lynch syndrome for 100%, and its presence may be caused by the mutations of other genes (PMS1, PMS2 and MLH3), responsible for DNA repair. Unfortunately there wasn't any opportunity to study their mutations. Conclusions: While studying the anamnesis of life and disease of women it was revealed that she had multiple primary tumor with lesions of the breast, urinary bladder, thyroid, uterus and other organs. This study shows that neoplastic tissue in all cases had high rates of cell proliferation, their antiapoptotic stability, expression of prognostically unfavorable-receptors, and absence of favorable prognostic markers. Histological study revealed high rates of malignant neoplastic tissue. It indicates to the existence of common mechanisms of malignant tumors and their genetic predisposition that can be clearly observed in many generations of patient.

Clinical Characteristics and Prognosis Associated with Multiple Primary Cancers in Breast Cancer Patients

“…Although many studies have been performed regarding MPCs, these have usually taken the form of case reports [ 11 12 13 ]. There have been several analytic clinical studies on MPCs, but few analytic clinical studies related to breast cancer with MPCs have been reported.…”

Striking Multiple Primary Tumors that underwent Whipple Procedure due to Periampullary Carcinoma: An Analysis of 21 Cases

“…Especially the mutations in TP53 gene also known as the tumor suppressor gene are also thought to play a role in the development of MPT. In a genetic case study by Romaniuk et al, 9 they have demonstrated that cell proliferation potential and antiapoptotic stability are high in cases with MPT. There is no such genetic background study in our series.…”

“…In the literature, there are many case reports with 2 to 7 primaries. 8 9 There are publications reporting MPT cases as 18.4 to 33% synchronous and 66 to 81.6% as metachronous. 3 9 10 Synchronous lesions were found in four of the patients in our series and this was less compared with the literature ( Table 1 ).…”

A Method of Complex Evaluation of Morphological Structure of Ostiomeatal Complex Components, Lower Wall of Maxillary and Frontal Sinuses

“…In terms of surgery, it is advisable to pay special attention to a group of people with a large area of both the hooked process and the middle nasal concha, which is combined with larger than certain maximum transverse dimensions [18]. This should take into account the features of both general and local biomineralization of tissues in physiological and pathological processes [19], the importance of timely diagnosis of pathological processes of this localization, including in the presence of their unconventional course [20], as well as features of the influence of environmental factors on the morpho-functional state of the investigated tissues [21], and their regeneration [22,23]. Also it could be actual for performing of epidemiological anthropometric research [24].…”