Introduction. The occurrence of more than one primary cancer in the same
patient is not very common. Multiple cancer prevalence is about 7.9% and the
percentage is lower as the number of multiple primary cancers is higher. The
incidence of four or more primary cancers in one patient is very rare and
its prevalence is around 0.07%. Case Report. We report a rare case of a
female with four histopathologically confirmed primary malignant neoplasms.
The first tumor was endometrial carcinoma diagnosed at the age of 52. Three
additional metachronous tumors were diagnosed as follows: left breast
cancer, melanoma, and contralateral breast cancer. Extensive genetic testing
was performed and 19 genes were sequenced using the next generation
sequencing (BRCA1, BRCA2, ATM, BRIP1, CDH1, CHEK2, MSH2, MLH1, MSH6, PMS2,
EPCAM, NBN, NF1, PALB2, PTEN, RAD51C, RAD51D, STK11 and TP53). Even with the
existing indicators of genetic etiology, this case showed no pathogenic
mutations in any of these genes. This indicates the existence of other
underlying mechanisms such as hormonal factors, previous treatment of the
primary and subsequent tumors, environmental factors, gene-gene and
gene-environment interactions, as well as immunosuppression that could
increase the risk for the second and subsequent malignancies. Conclusion.
Detailed information on the biology of multiple primary tumors is important
for both clinicians and cancer patients during medical management following
primary treatment. In addition, genetic information is very important
because it has future implications for both patients and their family
members.
Genetic characteristics of a patient with multiple primary cancers: A case report
