A case of multiple primary malignancies including peritoneal mesothelioma surviving over 11 years

Our plain-English summary of A case of multiple primary malignancies including peritoneal mesothelioma surviving over 11 years, by E. Esmati, S. Rezaei, F. Jafari (Clinical Case Reports, 2021).

The study

• Authors: E. Esmati, S. Rezaei, F. Jafari
• Journal: Clinical Case Reports
• Published: 2021;9(5):e04096
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Multiple primary malignancies are exceedingly rare, but they may occur sequentially in a patient, so in the follow-up of patients with a history of malignancy, always pay attention to second and third primary malignancies as well.

© 2021 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.

In plain English

This case report, by authors at a cancer institute in Tehran, Iran, described one woman who developed three separate primary cancers over 11 years. In March 2009, at age 55, she was diagnosed with stage I follicular lymphoma in the neck. Chemotherapy (four courses of R-CHOP) and radiotherapy cleared the lymph nodes. In April 2016, a mass of about 4 centimeters in the right groin was biopsied and diagnosed as mesothelioma, which the authors described as peritoneal mesothelioma. After cisplatin plus pemetrexed chemotherapy, CT scans showed the mass and enlarged lymph nodes had completely resolved. In May 2019, rectal adenocarcinoma was found and treated with chemoradiation followed by surgery. At age 66 she was alive. She was a housewife with no discrete occupational exposure to chemicals. The authors reported no prior history of asbestos exposure or abdominal radiation. No genetic study was done. The authors concluded that multiple primary cancers are exceedingly rare but can occur in sequence, and that peritoneal mesothelioma may completely regress with chemotherapy.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One woman, first seen in March 2009 at age 55. She was a housewife with hyperlipidemia and hypertension and no known family history of cancer. The authors are at a cancer institute in Tehran, Iran.
• Exposure: The authors reported no prior history of asbestos exposure and no abdominal radiation. She had no discrete occupational exposure to chemicals. Her first cancer was treated with chemotherapy and radiotherapy to the neck.
• Main results:
  • First cancer (2009): stage I follicular lymphoma of the neck lymph nodes. It was treated with four courses of R-CHOP chemotherapy followed by radiotherapy, and the neck lymph nodes completely resolved.
  • Second cancer (April 2016): an approximately 4 centimeter mass in the right groin, with enlarged abdominal lymph nodes. Biopsy and immunohistochemistry gave a diagnosis of mesothelioma, confirmed by two pathologists. The authors described it as peritoneal mesothelioma.
  • After cisplatin plus pemetrexed chemotherapy, abdominopelvic CT showed that the groin mass and enlarged lymph nodes had completely resolved.
  • Third cancer (May 2019): rectal adenocarcinoma, stage T3 N2 M0, found incidentally on a pelvic CT. It was treated with neoadjuvant chemoradiation followed by surgery.
  • At the time of the report the patient was a 66-year-old woman and alive: 11 years after the lymphoma diagnosis, 4 years after the mesothelioma diagnosis, and 1 year after the rectal adenocarcinoma diagnosis.
• The authors' conclusion: The authors concluded that multiple primary malignancies are exceedingly rare but may occur in sequence in one patient. They also concluded that peritoneal mesothelioma, known as a fatal cancer, may completely regress with chemotherapy and allow survival for many years. They suggested that a genetic study may help explain the cause when cancers occur without a well-known risk factor.
• Limitations the authors state:
  • No genetic study was done on the patient. The authors' suggestion of a shared genetic cause (such as an ALK rearrangement) was therefore hypothetical.

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma.

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