A Rare Case of Triple Malignancy: Non Hodgkin Lymphoma, Carcinoma of Breast and Squamous Cell Carcinoma of Tongue in a Single Patient

We are reporting a case of having triple malignancy including Non Hodgkin Lymphoma (NHL), Carcinoma breast, Squamous cell carcinoma (SCC) of the tongue. Triple malignancy is a very rare occurrence. Cancer patient are at increased risk of developing a subsequent primary tumour. Prevalence of multiple primary malignancies is slowly increasing due to prolonged survival of cancer patients with advances in diagnostic and therapeutic modalities. The reasons may be environmental modifications, genetic predisposition or therapy-induced. People who have had non-Hodgkin lymphoma (NHL) can get any type of second cancer, but they have an increased risk of certain cancers, including carcinoma lung, skin, tongue, bladder, colon, kidney etc. Radiation therapy to the chest increases the risk of breast cancer.Anwer Khan Modern Medical College Journal Vol. 9, No. 1: Jan 2018, P 75-78

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Increased risk of second primary tumours in patients with oesophageal squamous cell carcinoma: A nationwide study in a Western population

United European Gastroenterology Journal ◽

10.1177/2050640620977129 ◽

2020 ◽

pp. 205064062097712

Author(s):

Steffi EM van de Ven ◽

Janne M Falger ◽

Rob HA Verhoeven ◽

Robert J Baatenburg de Jong ◽

Manon CW Spaander ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Digestive Tract ◽

Squamous Cell ◽

Primary Tumour ◽

Second Primary ◽

Oesophageal Squamous Cell Carcinoma ◽

Increased Risk ◽

Second Primary Tumours ◽

Multiple Primary

Background Patients with primary oesophageal squamous cell carcinoma are at risk of developing multiple primary tumours in the upper aero digestive tract. To date, most studies are performed in the Asian population. We aimed to evaluate the risk of multiple primary tumours in the upper aero digestive tract and stomach in patients with oesophageal squamous cell carcinoma in a Western population. Methods We performed a nationwide, retrospective cohort study in collaboration with the Netherlands Cancer Registry. Patients with primary oesophageal squamous cell carcinoma, diagnosed between 2000–2016, were included. Primary endpoints were synchronous and metachronous multiple primary tumour risk. Results The cohort consisted of 9058 patients, diagnosed with oesophageal squamous cell carcinoma (male: 57.3%, median age 67 years). In 476 patients (5.3%), 545 multiple primary tumours have been diagnosed. Most of them were located in the head and neck region (49.5%). Among all multiple primary tumours, 329 (60.4%) were diagnosed synchronously (<6 months after oesophageal squamous cell carcinoma diagnosis) and 216 (39.6%) metachronously (≥6 months). Patients with oesophageal squamous cell carcinoma had a significantly increased risk of both synchronous (standardised incidence ratio 10.95, 99% confidence interval 9.40–12.53) and metachronous multiple primary tumours (standardised incidence ratio 4.36, 99% confidence interval 3.56–5.10), compared to the general population. The median interval to metachronous second primary tumour diagnosis was 3.0 years (interquartile range 1.8–5.9). Conclusion Approximately one in 20 patients with primary oesophageal squamous cell carcinoma have a second primary tumour in the upper aero digestive tract or stomach, either at the time of oesophageal squamous cell carcinoma diagnosis or at a later stage. As second primary tumours occur at an increased risk compared to the general population, prospective studies are necessary to investigate the yield and survival benefit of screening for second primary tumours in patients with oesophageal squamous cell carcinoma.

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Aggressive squamous cell carcinoma as a harbinger of non-Hodgkin lymphoma

JAAD Case Reports ◽

10.1016/j.jdcr.2018.07.008 ◽

2018 ◽

Vol 4 (9) ◽

pp. 869-871

Author(s):

Daniel J. Callaghan ◽

Abigail Waldman

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Hodgkin Lymphoma ◽

Squamous Cell ◽

Non Hodgkin Lymphoma

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Distinguishing Non-Hodgkin Lymphoma From Squamous Cell Carcinoma Tumors of the Head and Neck by Computed Tomography Parameters

The Laryngoscope ◽

10.1097/00005537-200206000-00026 ◽

2002 ◽

Vol 112 (6) ◽

pp. 1079-1083 ◽

Cited By ~ 10

Author(s):

Andrew C. Urquhart ◽

Lawrence G. Hutchins ◽

Richard L. Berg

Keyword(s):

Computed Tomography ◽

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Head And Neck ◽

Hodgkin Lymphoma ◽

Squamous Cell ◽

Non Hodgkin Lymphoma

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Expanding Spectrum of Malignancies in ALPS: A Cancer Predisposing Syndrome?.

Blood ◽

10.1182/blood.v120.21.2149.2149 ◽

2012 ◽

Vol 120 (21) ◽

pp. 2149-2149 ◽

Cited By ~ 1

Author(s):

Katie Perkins ◽

Joie Davis ◽

Susan Price ◽

Julie Niemela ◽

Andreas R. Huber ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Hodgkin Lymphoma ◽

Squamous Cell ◽

Genetic Defect ◽

Cancer Surveillance ◽

Myelogenous Leukemia ◽

Unrelated Donor ◽

Cell Transplant ◽

Increased Risk

Abstract Abstract 2149 Background: Autoimmune lymphoproliferative syndrome (ALPS) is a disorder of apoptosis characterized by lymphadenopathy, splenomegaly and peripheral accumulation of TCR αβ+ CD4-/CD8- double-negative T lymphocytes (DNT cells), often leading to multilineage cytopenias. ALPS-FAS with germline FAS mutations is the most common form of ALPS and has been associated with an increased risk for lymphoma (Straus, Blood 2001). We have now identified additional malignancies in our cohort, further underscoring the importance of cancer surveillance in ALPS patients. Objective: This is an update of the ALPS-associated cancers within the NIH cohort consisting of 240 individuals with ALPS-FAS from 116 families and 106 patients with ALPS-U (undetermined genetic defect). Patients and demographics: We previously reported 11 patients in our ALPS cohort with Hodgkin lymphoma (HL) and 9 patients with B cell Non-Hodgkin lymphoma (NHL)(Rao and Oliveira, Blood 2011). Here we report 6 additional types of malignancies associated with ALPS in 5 patients. Four of these patients have an intracellular FAS mutation. The frequency of malignancies within our ALPS cohort is 7.2% (25/346 patients) with a male:female gender distribution of 20:5. The age at the time of cancer diagnosis ranged from 5 to 60 years (median 22years). Results: As outlined in the Table below, ALPS-FAS patient #45.2 developed squamous cell carcinoma of the tongue that eventually led to his death from complications. His son also had ALPS-FAS with lymphoma. ALPS-FAS patient # 197.1 developed testicular cancer with malignant mixed germ cell tumor with seminoma and embryonal carcinoma elements. Marked leukocytosis during the first cycle of BEP chemotherapy led to a diagnosis of chronic myelogenous leukemia (CML) based on detecting a BCR-ABL translocation by PCR in peripheral blood and bone marrow. A patient with ALPS-FAS who previously had lymphoma developed histiocytic sarcoma and died following failed alloBMT. ALPS-FAS patient #121.13 developed acinic tumor of the parotid gland. A patient with ALPS-U (i.e. undetermined genetic defect) developed Ph+ acute lymphoblastic leukemia treated with an allogenic matched unrelated donor stem cell transplant and he is currently doing well. Conclusion: Although lymphoma continues to be the most common type of malignancy seen in ALPS patients, we have observed additional types of cancers in this population suggesting a broader cancer predisposition than previously thought. While none of these additional cancers, except for squamous cell carcinoma, have been previously associated with somatic FAS mutation in the Catalogue of Somatic Mutations in Cancer (http://cancer.sanger.ac.uk/cancergenome/projects/cosmic/), germline mutations affecting the intracellular component of the Fas protein confer a greater risk for developing malignancy as 22 malignancies were noted among 200 ALPS-FAS patients with such intracellular mutations. While this limited sample size does not allow us to definitively associate these cancers with ALPS, our findings highlight the need for active cancer surveillance in ALPS patients. Moreover, ALPS should be suspected in patients with sporadic lymphomas and other cancers that have a pertinent clinical and family history of cytopenias, hypersplenism and lymphoproliferation. Disclosures: No relevant conflicts of interest to declare.

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Comparison of CT Findings in Non-Hodgkin Lymphoma and Squamous Cell Carcinoma of the Maxillary Sinus

Acta Radiologica ◽

10.1177/028418519203300604 ◽

1992 ◽

Vol 33 (6) ◽

pp. 523-527 ◽

Cited By ~ 10

Author(s):

S. Matsumoto ◽

H. Shibuya ◽

S. Tatera ◽

E. Yamazaki ◽

S. Suzuki

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Maxillary Sinus ◽

Hodgkin Lymphoma ◽

Squamous Cell ◽

Bone Destruction ◽

Cervical Lymphadenopathy ◽

Tissue Mass ◽

Non Hodgkin Lymphoma ◽

Ct Findings

The findings at CT in 11 patients with primary non-Hodgkin lymphoma (NHL) of the maxillary sinus were compared with the CT findings in 21 patients with squamous cell carcinoma (SCC) of the maxillary sinus. In NHL, the segmental bone destruction was in alignment with the bony wall with a massive tumor infiltration into the neighboring structures. In contrast, all patients with SCC were characterized by a soft tissue mass with aggressive bone destruction. About half of the patients with NHL had cervical lymphadenopathy. Post-treatment recalcification of previous bone destruction was seen in 4 out of 5 NHL patients on follow-up CT. In the patients with SCC, only a few had metastatic lymphadenopathy, and no recalcification occurred after treatment. CT is therefore of importance in differentiating NHL from SCC of the maxillary sinus.

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