Asymptomatic synchronous quintuple primary cancers

Gynecol Obstet Invest. 2012;74(4):324-8. doi: 10.1159/000339135. Epub 2012 Jul 6.

Abstract

We encountered a 46-year-old woman with synchronous quintuple primary cancers. She did not present with any symptoms, and her tumors were discovered at a gynecological screening. She had clear cell adenocarcinoma of the right ovary, moderately differentiated endometrioid adenocarcinoma of the endometrium, moderately differentiated adenocarcinoma of the ascending colon, well-differentiated adenocarcinoma of the rectum, and poorly differentiated papillary adenocarcinoma of the left lung. A fluorodeoxyglucose-positron emission tomography and other imaging techniques were extremely useful for the diagnosis of multiple primary cancers. Moreover, MSH2 protein expression was absent in the tumors of the ovary, endometrium, ascending colon, and rectum, while the rectal cancer also lacked MLH1 protein. These findings suggested that an abnormality of DNA mismatch repair genes was responsible for carcinogenesis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptor Proteins, Signal Transducing / genetics
  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / genetics
  • Adenocarcinoma / therapy
  • Adenocarcinoma, Papillary / diagnosis
  • Adenocarcinoma, Papillary / genetics
  • Adenocarcinoma, Papillary / therapy
  • Asymptomatic Diseases
  • Carcinoma, Endometrioid / diagnosis
  • Carcinoma, Endometrioid / genetics
  • Carcinoma, Endometrioid / therapy
  • Colonic Neoplasms / diagnosis
  • Colonic Neoplasms / genetics
  • Colonic Neoplasms / therapy
  • DNA Mismatch Repair
  • Endometrial Neoplasms / diagnosis
  • Endometrial Neoplasms / genetics
  • Endometrial Neoplasms / therapy
  • Female
  • Humans
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / genetics
  • Lung Neoplasms / therapy
  • Lymphatic Metastasis
  • Magnetic Resonance Imaging
  • Middle Aged
  • MutL Protein Homolog 1
  • Neoplasms, Multiple Primary / diagnosis
  • Neoplasms, Multiple Primary / genetics*
  • Neoplasms, Multiple Primary / therapy
  • Nuclear Proteins / genetics
  • Ovarian Neoplasms / diagnosis
  • Ovarian Neoplasms / genetics
  • Ovarian Neoplasms / therapy
  • Positron-Emission Tomography
  • Rectal Neoplasms / diagnosis
  • Rectal Neoplasms / genetics
  • Rectal Neoplasms / therapy
  • Tomography, X-Ray Computed

Substances

  • Adaptor Proteins, Signal Transducing
  • MLH1 protein, human
  • Nuclear Proteins
  • MutL Protein Homolog 1