Elevated risk of second malignant neoplasms in pediatric germ cell tumor patients.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 10010-10010
Author(s):  
Maria Clarissa de Faria Soares Rodrigues ◽  
Carlos Rodriguez-Galindo ◽  
Karina Braga Ribeiro ◽  
A. Lindsay Frazier
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumors ◽  
Malignant Neoplasm ◽  
Primary Diagnosis ◽  
Second Primary ◽  
Malignant Neoplasms ◽  
Primary Malignancy ◽  
Second Malignant Neoplasm ◽  
Primary Tumors ◽  
Treatment Type

10010 Background: The probability of cure is very high for children with germ cell tumors (GCT), but late effects from cisplatinum can be quite significant. In addition to the immediate effects of oto-, neuro and nephrotoxicity, data from men treated for testicular cancer shows that the rate of second malignant neoplasm (SMN) is doubled and that a man treated before age 20 has a 50% chance of SMN by age 75. This study was designed to assess the risk of SMN among individuals treated for malignant GCT during childhood. Methods: We included all patients 0-19 years old with a primary diagnosis of malignant GCT registered in the Surveillance, Epidemiology and End Results (SEER) in the period 1973-2008. We analyzed tumors occurring at least 12 months after the first primary. Standardized incidence ratios (SIR) and 95% confidence intervals (CI) were calculated using SEER Stat, version 8.0.1. Results: The cohort comprised 1997 patients (798 women and 1,199 men); 86.3% had primary gonadal tumors (91% in men and 79.5% in women). The median age at diagnosis of the primary malignancy was 17 years (17 for males ; 15 for females), and for second malignancies was 27 (27 for males; 30 for females). Fifty eight SMNs were observed (21 in females; 37 in males). Among women, higher risk was observed to developing breast cancer (n=5; SIR=1.29; 95% CI= 0.42-3.02), thyroid cancer (n=5; SIR= 3.40; 95% CI= 1.1-7.93) and brain cancer (n=3; SIR= 9.19; 95% CI=1.89-26.85). Twenty-seven out of 37 second primary tumors observed in men were contralateral testicular tumors, conferring a 16.2 fold higher risk of developing this neoplasm (95% CI= 10.67-23.58). When the analysis excluded testis as a second site, a higher risk was noted for the development of pancreatic cancer (SIR=19.06; 95% CI=2.31-68.83) and leukemia (SIR=3.55; 95% CI=0.43-12.81). Conclusions: Rates of SMN are elevated in both men and women treated as children for pediatric germ cell tumors. Men need to be made aware of risk in contralateral testicle. The rates of SMN may continue to rise with longer follow up. The attribution of treatment type to risk of SMNs is not possible due to the lack of this information in SEER database.

scholarly journals Metachronous Multiple Primary Malignant Neoplasms of the Stomach and the Breast: Report of Two Cases With Review of Literature

2014 ◽  
Vol 99 (1) ◽  
pp. 52-55 ◽  
Author(s):  
Vilvapathy Senguttuvan Karthikeyan ◽  
Sarath Chandra Sistla ◽  
Ramachandran Srinivasan ◽  
Debdatta Basu ◽  
Lakshmi C. Panicker ◽  
...  
Keyword(s):  
Malignant Neoplasm ◽  
Second Primary ◽  
Malignant Neoplasms ◽  
Rare Occurrence ◽  
Review Of Literature ◽  
Second Primary Malignancy ◽  
Carcinoma Of The Breast ◽  
Primary Malignancy ◽  
Multiple Primary ◽  
Second Primary Malignancies

Abstract Multiple primary malignant neoplasm is the occurrence of a second primary malignancy in the same patient within 6 months of the detection of first primary (synchronous), or 6 months or more after primary detection (metachronous). Multiple primary malignant neoplasms are not very frequently encountered in clinical practice. The relative risk for a second primary malignancy increases by 1.111-fold every month from the detection of the first primary malignancy in any individual. We present 2 patients treated for carcinoma of the breast who developed a metachronous primary malignancy in the stomach to highlight the rare occurrence of multiple primary malignant neoplasms. These tumors were histologically dissimilar, with distinct immunohistochemical parameters. The importance lies in carefully identifying the second primary malignancies, not dismissing them as metastases, and treating them accordingly.

scholarly journals Clinicomorphological Study Of Ovarian Lesions

2014 ◽  
Vol 3 (4) ◽  
pp. 17-24
Author(s):  
Sushna Maharjan
Keyword(s):  
Germ Cell ◽  
Abdominal Mass ◽  
Germ Cell Tumors ◽  
Malignant Neoplasm ◽  
Benign Tumors ◽  
Malignant Neoplasms ◽  
Presenting Symptoms ◽  
Epithelial Tumors ◽  
Neoplastic Lesions ◽  
The Common

This prospective study was conducted at College of Medical Sciences-Teaching Hospital (CMS-TH) during December 2008 to May 2010. One hundred and fifty cases were analyzed. Age of the patients, parity, presenting symptoms, types of sur­gery, clinical diagnosis and complications were retrieved from case sheets. Surface epithelial tumors were more frequently observed above 30 years of age, (62.07%) cases. During 1st to 3rd decades of life, 62.8% germ cell tumors were seen; and sex cord tumors were seen in age group 41-60 years only. For all age groups, benign tumors were common than malignant tumors. There were 10.7% unmarried patients, 5.33% nulliparous, 35.55% of parity 1 to 2; 4% pregnant and 20 % postmeno­pausal women. There were 86.67% cases neoplastic, and 13.33% non-neoplastic ovarian lesions; 93.85% benign, 5.38% malignant and 0.77% borderline tumors. Surface epithelial tumors were the most common tumors (53.84%) followed by germ cell tumors (43.85%), constituted 46.7% and 38% among all ovarian lesions. The commonest benign tumors were serous cystadenomas and mature cystic teratomas, constituted 40% cases each. Dysgerminoma was the common malignant neoplasm (2.31%), all were seen in adolescents. Most of the other malignant neoplasms were observed above 40 years of age. Seventy percent (70%) of non-neoplastic lesions were hemorrhagic corpus luteum cysts. The commonest presenting symptom was pain in the lower abdomen (82%) followed by abdominal mass/ or distension (48.7%). Constitutional symp­toms were observed in malignant cases only. Grossly, majority of the ovarian lesions were of size ranging 5 to 15 cm; and 89.93% cystic lesions. There were 48.7% lesions in the right ovary and 45.3% in the left ovary; 6% bilateral ovarian lesions, all of which were observed in benign and non-neoplastic lesions. The common complication observed was torsion (6.7%) followed by rupture of the cysts (6%). Journal of Chitwan Medical College 2013; 3(4); 17-24 DOI: http://dx.doi.org/10.3126/jcmc.v3i4.9549

Bilateral testicular germ cell tumors.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 392-392
Author(s):  
Stephanie A. Curreri ◽  
Sarah C. Markt ◽  
Rowan Miller ◽  
Elizabeth O'Donnell ◽  
Brandon David Bernard ◽  
...  
Keyword(s):  
Testicular Cancer ◽  
Germ Cell ◽  
Cause Of Death ◽  
Germ Cell Tumors ◽  
Malignant Neoplasm ◽  
Patient Characteristics ◽  
Second Malignant Neoplasm ◽  
Testicular Germ Cell ◽  
Risk Of Death ◽  
Increased Risk

392 Background: Germ cell tumors (GCTs), both seminomatous and non-seminomatous, account for greater than 90% of testicular cancers. While bilateral testicular GCTs are rare, the incidence of bilateral tumors has increased over time. Methods: 668 cases of bilateral and 38,593 cases of unilateral testicular GCTs were reported between 1973 and 2011 by the SEER database. Patient characteristics and tumor features were analyzed. Results: The incidence of bilateral GCTs among men with testicular GCTs was 1.7% (668 of 39,261 total cases). Among the 668 men with bilateral GCTs, 53% (n=353) of second GCTs occurred within three years after the first cancer. 29% (n=196) of bilateral tumors occurred synchronously. Among patients with bilateral GCTs, 378 first GCTs and 466 second GCTs were seminomatous. 43% of bilateral cases were concordant seminomatous GCTs, 16% were concordant non-seminomas, and 41% were discordant histologies. 68% of unilateral GCTs, 70% of first GCTs, and 82% of second GCTs were staged as Localized disease. Testicular cancer was the cause of death for 4% (n=1,630) of men with a unilateral GCT and 1% (n=8) of men with bilateral GCTs. A second malignant neoplasm (SMN) was the cause of death for 2% (n=736) of men with a unilateral GCT and 2% (n=16) of men with bilateral GCTs. Conclusions: Among men with bilateral testicular GCTs, 59% had concordant histological diagnoses between their first and second tumor. Most (53%) second cancers among men with bilateral tumors occurred within three years after diagnosis of first cancers. Men who experience bilateral testicular GCTs do not appear to have an increased risk of death due to testicular cancer or a subsequent non-germ cell malignant neoplasm compared to men with a unilateral testicular GCT. [Table: see text]

Paraneoplastic Limbic Encephalitis Secondary To Mixed Non-Seminomatous Germ Cell Tumours

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S55-S56
Author(s):  
A Ullah ◽  
S Heneidi ◽  
P Biddinger ◽  
N Patel ◽  
C Wehrle ◽  
...  
Keyword(s):  
Germ Cell ◽  
Limbic Encephalitis ◽  
Germ Cell Tumors ◽  
Testicular Tumor ◽  
Primary Malignancy ◽  
Rare Presentation ◽  
Paraneoplastic Limbic Encephalitis ◽  
Nonseminomatous Germ Cell Tumor ◽  
Aortic Lymph Node ◽  
Alteration Of Consciousness

Abstract Casestudy: Testicular tumors account for 1–2% of all tumors in men, with 95% of these being germ cell tumors. The main risk factor for the development of testicular cancer is cryptorchidism. Paraneoplastic limbic encephalitis is a rare sequela of testicular tumor associated with anti-Ma2 and KLH11 antibodies. The most effective treatment for paraneoplastic limbic encephalitis is treatment of the primary malignancy. We present a 41-year-old male that presented to the emergency department with two weeks of episodic alteration of consciousness and memory disturbances. Negative neurologic evaluation and imaging led to concern for a paraneoplastic process from a distant malignancy. CT imaging revealed an enlarged, necrotic para-aortic lymph node and subsequent ultrasound demonstrated a right sided testicular mass. Right radical orchiectomy was performed. Microscopically, the mass consisted of mixed respiratory epithelium, gastrointestinal glands and squamous epithelium with keratinization consistent with a post-pubertal testicular teratoma with associated in-situ germ cell neoplasia. Resection of the para-aortic mass revealed large anaplastic cells with epithelioid features, nuclear pleomorphism and frequent mitoses. Immunostaining was positive for Pan-Keratin and OCT4, consistent with poorly differentiated embryonal carcinoma. Resection of the primary and metastatic disease, as well as treatment with corticosteroids resulted in resolution of the encephalitis. This presentation of severe neurological disturbances in the setting of a metastatic mixed nonseminomatous germ cell tumor represents a rare presentation of paraneoplastic limbic encephalitis.

scholarly journals REVIEW OF THE CURRENT STATE OF THE PROBLEM OF PRIMARY DETECTION OF MALIGNANT TUMORS OF THE CAVITY

2019 ◽  
Vol 15 (2) ◽  
pp. 50-55
Author(s):  
Наталья Нуриева ◽  
Natal'ya Nurieva ◽  
Александр Гузь ◽  
Aleksandr Guz ◽  
Александр Захаров ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Head And Neck ◽  
Malignant Tumors ◽  
Malignant Neoplasm ◽  
Diagnostic Procedures ◽  
Primary Diagnosis ◽  
Malignant Neoplasms ◽  
Dental Rehabilitation ◽  
Late Treatment ◽  
Clinically Significant

Subject: malignant neoplasms of the oral cavity, primary detectability, appeal to specialists, terms of treatment before hospitalization. Objective: based on a five-year analysis of the medical records of patients with a verified diagnosis of malignant neoplasm of the oral cavity, to identify significant criteria for primary diagnosis, doctors of the first contact, including non-cancer profile. Methodology. Malignant neoplasms occupy one of the leading places among all medical and social problems. This is due to a number of reasons, among which are particularly high rates of morbidity and mortality, late treatment of patients and frequent disability. the Purpose of early detection of malignant tumors of the oral cavity is to increase the effectiveness and radicality of treatment, increase the possibility of dental rehabilitation, reduction of disability. To write this article, we conducted a five-year analysis of the primary detection of malignant tumors of the oral cavity in 76 patients hospitalized for treatment in the head and neck Department of the Chelyabinsk district Oncology center. All patients with histologically confirmed diagnosis. Everyone needs specialized anti-tumor treatment. In addition to standard diagnostic procedures, all patients were surveyed on the issues of primary complaints and appeals to medical specialists. Results. On the example of the received questionnaires as well as the standard medical examinations conducted upon admission to the head and neck Department, the trends of the primary referral of patients to primary contact doctors, the terms of treatment before referral to a specialized oncological institution, the stage of the process and the presence of metastasis of the primary focus during treatment, the presence of aggravating factors are analyzed. Conclusions. The results for the five-year period in patients with primary malignant neoplasm of the oral cavity were evaluated, practical recommendations on clinically significant symptoms of malignant tumors of the oral cavity, orientation on the timing of observation were given.

Primary Malignant Neoplasms Associated with Chronic Lymphocytic Leukemia

1980 ◽  
Vol 66 (4) ◽  
pp. 431-438 ◽  
Author(s):  
Armando Santoro ◽  
Franco Rilke ◽  
Franca Franchi ◽  
Silvio Monfardini
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Alkylating Agents ◽  
Malignant Lesion ◽  
Lymphocytic Leukemia ◽  
Second Primary ◽  
Malignant Neoplasms ◽  
Primary Malignancy ◽  
Second Primary Neoplasms ◽  
Primary Neoplasms ◽  
Cellular And Humoral Immunity

Over the past 2 decades there has been an almost exponential increase in the frequency with which cases of leukemia associated with another primary malignant lesion have been reported. In this study we reported the occurrence of a second primary neoplasm in 82 consecutive cases of chronic lymphocytic leukemia (CLL) admitted to the Istituto Nazionale Tumori of Milan from September 1962 to December 1978. In 16 of these (19.5%), an associated neoplasm was diagnosed subsequently (8 cases) or concurrently (8 cases) to CLL. Head and neck carcinomas and breast cancer had the highest incidence (5 and 3 cases, respectively). The results of this study further support the hypothesis that patients with CLL are prone to develop subsequent cancer. The defective cellular and humoral immunity in CLL may have an etiological role in the development of an additional primary malignancy. Although alkylating agents are known carcinogens in experimental animals and man, our results support the lack of a correlation between treatment with alkylating agents and incidence of second primary neoplasms, as demonstrated by Greene et al. (10).

Second malignant neoplasms in children treated for rhabdomyosarcoma. Intergroup Rhabdomyosarcoma Study Committee.

1993 ◽  
Vol 11 (2) ◽  
pp. 262-270 ◽  
Author(s):  
R Heyn ◽  
V Haeberlen ◽  
W A Newton ◽  
A H Ragab ◽  
R B Raney ◽  
...  
Keyword(s):  
Cumulative Incidence ◽  
Alkylating Agent ◽  
Age Groups ◽  
Malignant Neoplasm ◽  
Bone Sarcoma ◽  
Incidence Density ◽  
Malignant Neoplasms ◽  
Tumor Type ◽  
Second Malignant Neoplasm ◽  
Li Fraumeni Syndrome

PURPOSE This study was performed to determine the incidence and risk factors involved in the development of a second malignant neoplasm (SMN) after treatment of primary rhabdomyosarcoma (RMS) in patients enrolled onto Intergroup Rhabdomyosarcoma Studies I and II (IRS I and II). PATIENTS AND METHODS There were 1,770 patients with primary RMS entered onto IRS I and II between 1972 and 1984. They were treated with chemotherapy and, in most instances, radiotherapy according to randomized or assigned regimens based on clinical grouping. Median follow-up time for these patients was 8.4 years. Incidence density (ID) was calculated for each study and for treatment and age groups. The 10-year cumulative incidence was estimated for each study. RESULTS Twenty-two SMNs have been reported through 1991. The most common tumor type was a bone sarcoma followed by acute nonlymphoblastic leukemia (ANLL). The median time to the development of an SMN was 7 years (range, 1 11/12 to 15 9/12 years). The 10-year cumulative incidence rate was 1.7% for both studies. ID and cumulative incidence estimates were highest for patients who received both an alkylating agent and radiotherapy. The majority of patients for whom family histories were available had either neurofibromatosis themselves or a family history that suggested the Li-Fraumeni syndrome (LFS). CONCLUSION The results of this study suggest that genetic abnormalities play a prominent role in the development of an SMN after therapy for a primary RMS. Chemotherapy with an alkylating agent and radiotherapy play significant roles in the development of an SMN compared with patients who received only one of these therapeutic modalities.

scholarly journals Evaluation of Circulating miRNA Biomarkers of Testicular Germ Cell Tumors during Therapy and Follow-up―A Copenhagen Experience

Cancers ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 759
Author(s):  
Nina Mørup ◽  
Ewa Rajpert-De Meyts ◽  
Anders Juul ◽  
Gedske Daugaard ◽  
Kristian Almstrup
Keyword(s):  
Germ Cell ◽  
Tumor Markers ◽  
Germ Cell Tumors ◽  
Primary Diagnosis ◽  
University Hospital ◽  
Testicular Germ Cell Tumors ◽  
Testicular Germ Cell ◽  
Circulating Mirna ◽  
Serum Tumor Markers

New microRNA-based serum biomarkers (miRNA-367-3p, -371a-3p, -372-3p, and -373-3p) have shown great potential for the detection of testicular germ cell tumors (TGCTs), but few studies have investigated the clinical utility and performance of these tests in treatment monitoring. In this study, circulating miRNA levels were measured, together with serum tumor markers alpha-fetoprotein (AFP), β-subunit of human chorionic gonadotropin (β-HCG) and lactate dehydrogenase (LDH) in 406 consecutive blood samples obtained during the treatment and follow-up of 52 TGCT patients at the Copenhagen University Hospital. After testing three different methods of RNA isolation from peripheral blood and PCR quantification in a subset of samples (n = 15), the best performing setup of targeted isolation of miRNAs inside and outside exosomes was selected to analyze all samples. At primary diagnosis, the miRNAs significantly outperformed the serum tumor markers, with a sensitivity and specificity of 78% and 100% (based on 40 patients), respectively. The picture was not as clear when patient trajectories were investigated, with both positive and negative signals for miRNAs and serum tumor markers. To establish whether measuring miRNAs adds value beyond the primary diagnosis, large prospective clinical trials comparing miRNAs and classical tumor markers during the treatment and follow-up of TGCT patients are needed.

scholarly journals Impact of Teratoma on the Cumulative Incidence of Disease-Related Death in Patients With Advanced Germ Cell Tumors

2019 ◽  
Vol 37 (26) ◽  
pp. 2329-2337 ◽  
Author(s):  
Samuel A. Funt ◽  
Sujata Patil ◽  
Darren R. Feldman ◽  
Robert J. Motzer ◽  
Dean F. Bajorin ◽  
...  
Keyword(s):  
Germ Cell ◽  
Cumulative Incidence ◽  
Mature Teratoma ◽  
Germ Cell Tumors ◽  
Adverse Outcomes ◽  
Term Survival ◽  
Risk Status ◽  
Primary Tumors ◽  
Platinum Based Chemotherapy

PURPOSE In men with metastatic germ cell tumors (GCTs), risk-directed treatment is determined, in part, by a distinction between seminoma and nonseminomatous GCT (NSGCT). The importance of NSGCT cell type is uncertain. We evaluated the long-term impact of teratoma on survival in patients with NSGCT. METHODS Prechemotherapy, primary tumors from patients who received platinum-based chemotherapy were studied, and the histology was confirmed by a genitourinary pathologist. The cumulative incidence of disease-related death (CIDD) was the primary end point, and a competing-risk analysis was performed. RESULTS Tumors were available from 232 patients, including 193 with NSGCT. An element of teratoma was present in 82 NSGCT primary tumors (42%). With a median follow-up of 17 years (range, 0.3 to 35 years), 58 patients with NSGCT died, 47 as a result of GCT and 11 as a result of other causes. Most GCT deaths occurred within the first 5 years and were associated with pretreatment risk status ( P < .001). Death as a result of other causes rose steadily after 15 years and was not associated with risk status ( P = .66). A higher CIDD was observed in patients who had NSGCT with teratoma than those with NSGCT without teratoma and seminoma (5-year CIDD rate, 27.4%, 17.4%, and 10.3%, respectively; P = .03). A higher CIDD was observed in patients who had NSGCT with mature teratoma compared with those with either NSGCT with immature teratoma or NSGCT without teratoma (5-year CIDD rate, 38.1%, 19.9%, and 17.4%, respectively; P = .01). CONCLUSION The presence of teratoma, particularly mature teratoma, in an NSGCT primary tumor is associated with a higher CIDD, consistent with the hypothesis that differentiation is associated with adverse outcomes. Death as a result of non-GCT causes is not associated with risk status and must be separated from GCT death when evaluating long-term survival.

Different Clinical Features of Primary and Secondary Tumors in Patients with Multiple Malignancies

2005 ◽  
Vol 91 (4) ◽  
pp. 317-320 ◽  
Author(s):  
Mehmet Artac ◽  
Hakan Bozcuk ◽  
Mustafa Ozdogan ◽  
Ayşe Nur Demiral ◽  
Alpay Sarper ◽  
...  
Keyword(s):  
Clinical Features ◽  
Second Primary ◽  
Multiple Primary Cancer ◽  
Breast Cancers ◽  
Primary Malignancy ◽  
Primary Tumors ◽  
Multiple Malignancies ◽  
Secondary Tumors ◽  
Second Tumors ◽  
Second Primaries

Clinical features of the first and second primaries in patients with multiple malignancies have not been extensively studied. We compared patient and treatment characteristics of the primary malignancy in 48 consequent multiple primary cancer patients with those of the second primary in the same cohort. The second primaries comprised fewer breast cancers; 29.2% of primaries as opposed to 10.4% of second tumors were breast cancer (P = 0.049). In addition, primary tumors tended to be at a lower TNM stage than secondary tumors (P = 0.060). The median overall survival after the diagnosis of the first primary for the whole cohort was 22.3 years (95% CI, 2.0–42.5) and the median time to presentation of the second malignancy was 38 months after the diagnosis of the first primary (range, 0 to 384). Therefore, the prognosis of cancers in the multiple malignancy group appears to be good and they appear to have an indolent clinical behavior. Thus, we recommend a long screening time for secondary tumors after a curative treatment in patients with common cancers, taking into account the different occurrence patterns of second primaries with respect to first primaries.

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