Multiple primary or secondary malignancies after anticancer therapy were recently reported to be increasing in frequency. The authors describe a case of metachronous metastatic pulmonary basaloid carcinoma to the central nervous system that was discovered after chemotherapy and radiation therapy for cervical uterine carcinoma. Two different types of cancer developed within some interval. There's the possibility that a secondary pulmonary neoplasm developed after the chemotherapy and radiotherapy conducted as cervical cancer treatment.
Central Nervous System ; Drug Therapy* ; Lung Neoplasms ; Neoplasm Metastasis* ; Neoplasms, Second Primary ; Radiotherapy ; Uterine Cervical Neoplasms

Radiation-induced second malignancies (RISM) is one of the important late side effects of radiation therapy and has an impact on optimal treatment decision-making. Many factors contribute to the development of RISM such as age at radiation, dose and volume of irradiated area, type of irradiated organ and tissue, radiation technique and individual and family history of cancer. Exact mechanism of RISM is unknown. But nowadays, it is a growing concern in oncology because of the increased number of cancer survivors and efforts are being made to prevent or decrease the incidence of RISM. The primary search for articles was carried via Google Scholar and PubMed with keywords included ‘radiation induced malignancies, second malignancies, and chemotherapy induced malignancies’. Additional papers were found through references from relevant articles. In this review article, we have discussed about the pathogenesis, factors contributing to RISM, screening and prevention strategies of RISM.
Drug Therapy ; Humans ; Incidence ; Mass Screening ; Neoplasms, Second Primary ; Radiotherapy ; Survivors

We wanted to present the results of our experience with bilateral testis tumor and to suggest the effects of chemotherapy in suppressing the development of second primary testicular tumors. Between 1978 and 1997, 2,345 patients were treated for testicular tumor at The University of Texas M. D. Anderson Cancer Center. Of these, 2,107 had germ cell cancers. There were 22 (0.94%) cases of bilateral testicular tumor in the overall patient population and 21 (1.0%) cases among patients with germ cell cancer. We reviewed the medical records to determine the incidence of the histological subtype, the incidence of metachronous versus synchronous formation of contralateral tumors, and tumor stage in this patient population. We also examined the effect of chemotherapy in treating the first tumor and preventing the occurrence of a second tumor. Finally, we compared the effect of ultrasonography, serum tumor marker elevation, and physical examination in detecting second tumors. Only one contralateral germ cell tumor developed synchronously; all others developed metachronously. Fifty percent of first tumors were seminomas, compared to 55% of second tumors. The histologic concordance rate for first and second tumors was 35%. Tumor stage was higher among first tumors than second tumors. The majority of second tumors in patients who received chemotherapy for first malignancies tended to be metachronous seminomas. Ultrasonography detected 6 of 21 (28.6%) contralateral tumors before they were evident by physical examination or serum tumor marker elevation. Seminomas were more prevalent among patients with bilateral germ cell disease than patients with unilateral disease. Chemotherapy, when used as treatment for first tumors, may have some effect in preventing the development of nonseminomatous germ cell tumors in the contralateral testicle. Close follow-up of the contralateral testis with ultrasonography is essential for early detection of second tumors. The outcome for patients with bilateral testicular germ cell cancer is excellent, secondary to early detection.
Adolescence ; Adult ; Antineoplastic Agents/therapeutic use* ; Human ; Incidence ; Male ; Neoplasms, Multiple Primary/epidemiology ; Neoplasms, Second Primary/prevention & control* ; Neoplasms, Second Primary/epidemiology ; Testicular Neoplasms/pathology ; Testicular Neoplasms/drug therapy*

Primary duodenal adenocarcinoma is a rare malignant neoplasm accounting for 0.3% of all gastrointestinal tract carcinomas. We herein present one case of duodenal adenocarcinoma after duodenal neuroendocrine carcinoma. Poorly differentiated duodenal neuroendocrine carcinoma with liver metastasis (TxNxM1) was confirmed, and eight cycles of palliative chemotherapy (5-fluorouracil/etoposide/cisplatin) were administered. The patient was then in a clinically complete response status. About 1 year later, newly developed adenocarcinoma was detected at the same site. It was completely surgically resected, and the patient was cured.
Adenocarcinoma/*diagnosis/drug therapy ; Antineoplastic Agents/therapeutic use ; Duodenal Neoplasms/*diagnosis/drug therapy ; Humans ; Male ; Middle Aged ; Neoplasms, Second Primary/*diagnosis/drug therapy ; Neuroendocrine Tumors/*diagnosis/drug therapy

Radiotehrapy and chemotherapy can effectively control cancer but can also cause new second cancers to develop as long-term complications especially in childhood cancer. We experienced two patients with second malignant solid neoplasm who had been treated with radiation and chemotherapy for childhood cancers. One female patients with rhabdomyosarcoma of the right popliteal fossa was treated with radiotherapy at total dose of 54 Gy. Three years and seven months later, osterosarcoma developed in the field of radiation therapy. The other male patient with non-Hodgkin's lymphoma of the small bowel was treated with radiotherapy and leiomyosarcoma developed in the field of radiotherapy 18 years later. We reviewed the literature of the second malignant neoplasm in children in respect of risk factors. The risk for a second primay cancer following radiotherapy or chemotherapy emphasizes the need for life long follow-up of patients receiving such treatments. Particularly patients treated for childhood cancers.
Child* ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Leiomyosarcoma ; Lymphoma, Non-Hodgkin ; Male ; Neoplasms, Second Primary ; Radiotherapy* ; Rhabdomyosarcoma ; Risk Factors

OBJECTIVETo study the incidence of implantation metastasis of breast cancer in vacuum-assisted breast biopsy (VABB) needle tract in Chinese patients and evaluate the effect of neoadjuvant chemotherapy on needle tract metastasis following VABB.

METHODSThe breast cancer patients with established diagnosis by VABB were divided into two groups to receive open surgery or neoadjuvant chemotherapy prior to open surgery. The incidence of needle tract metastasis, disease-free survival (DFS) and overall survival (OS) were compared between the two groups.

RESULTSA total of 214 patients were enrolled, among whom 94 directly underwent surgeries and 120 had neoadjuvant chemotherapy before surgery. The two groups showed no significant differences in the incidence of needle tract metastasis (3.2% vs 0.8%, P=0.206), DFS (P=0.221), or OS (P=0.531).

CONCLUSIONThe incidence of needle tract metastasis is low after VABB, and neoadjuvant chemotherapy does not increase this risk.

Biopsy, Needle ; methods ; Breast ; Breast Neoplasms ; pathology ; Disease-Free Survival ; Female ; Humans ; Incidence ; Needles ; Neoadjuvant Therapy ; Neoplasms, Second Primary ; drug therapy ; Vacuum

BACKGROUND/AIMS: We aimed to investigate the incidence of second primary pancreatic cancer (PC) after colorectal cancer (CRC) and to identify risk factors associated with subsequent PC. METHODS: The observed incidence of a subsequent PC in patients with CRC was standardized using a population with CRC from the Korean Central Cancer Registry (KCCR). The expected incidence rate of PC was obtained by assuming that the select group experienced the same cancer incidence as the corresponding general population in the KCCR. RESULTS: The registry included 4,822 patients with CRC aged 45 to 74 years, representing 16,725.1 person-years of follow-up. Thirteen patients (0.3%) were diagnosed with a subsequent PC, and the overall age-adjusted incidence of second primary PC was 269.6 per 100,000 cases. In contrast, the overall incidence of primary PC in the general population was 18.68 per 100,000 individuals. The standardized incidence ratio of subsequent PC was 14.44, which was significantly higher in patients with CRC than in the general population. Sex, diabetes mellitus, smoking, body mass index, and a history of receiving chemotherapy as a treatment for CRC did not increase the risk of subsequent development of PC. CONCLUSIONS: The risk of a second primary PC was higher in patients with CRC. Further studies are needed to identify the risk factors and generate a screening strategy for cancer survivors.
Body Mass Index ; Colorectal Neoplasms* ; Diabetes Mellitus ; Drug Therapy ; Follow-Up Studies ; Humans ; Incidence ; Mass Screening ; Neoplasms, Second Primary ; Pancreatic Neoplasms* ; Risk Factors ; Smoke ; Smoking ; Survivors*

Despite the decreasing incidence and mortality from gastric cancer, it remains a major health problem worldwide. Ninety percent of cases are adenocarcinomas. Here, we report a case of gastric adenocarcinoma developed after successful treatment of prior primary gastric diffuse large B-cell lymphoma (DLBCL). Our patient was an elderly man with primary gastric DLBCL in whom complete remission was achieved after R-CHOP (cyclophosphamide, adriamycin, vincristine, prednisolone plus rituximab) chemotherapy. Helicobacter pylori infection persisted despite adequate treatment leading to sustained chronic gastritis. The mean time to diagnose metachronous gastric carcinoma was seven years. We believe that a combination of many risk factors, of which chronic H. pylori infection the most important, led to the development of gastric carcinoma following primary gastric lymphoma. In summary, patients who have been successfully treated for primary gastric lymphoma should be followed up at regular short intervals. H. pylori infection should be diagnosed promptly and treated aggressively.
Adenocarcinoma* ; Aged ; B-Lymphocytes* ; Doxorubicin ; Drug Therapy ; Gastritis ; Helicobacter pylori ; Humans ; Incidence ; Lymphoma ; Lymphoma, B-Cell* ; Mortality ; Neoplasms, Second Primary ; Prednisolone ; Risk Factors ; Stomach Neoplasms ; Vincristine

BACKGROUND: This study was undertaken to investigate the frequency, causes, and outcome of second malignancies(SM) following treatment of childhood cancer in Korea. METHODS: The Korean Society of Pediatric Hematology-Oncology(KSPHO) reviewed the records of patients who developed SM during the period of 1981-1997 through nationwide search. RESULTS: Twenty four cases were collected, among which 7 AML, 5 osteosarcoma and 5 ALL were observed. Fifteen of them were boys, and 9 girls (1.7:1). Familial cancer was registered in 5 cases among direct relatives. No interrelationship between first and SM was observed except in 2 retinoblastoma patients who developed osteosarcoma. The SM developed in a period of 8 to 144 months (mean:55 months) after the initiation of treatment for the first malignancy. Sixteen cases had radiotherapy for the first malignancy, and in 6 of them the SM developed in the irradiated area. Fifteen patients were treated with alkylating agents, 12 received anthracyclines and 7 received etoposide. They survived 1 to 110 months (mean:15 months) after development of the SM. Sixteen patients are dead, 3 currently free of disease, and 5 alive with disease. CONCLUSION: AML, osteosarcoma and ALL were most prevalent SM in Korean children. The mean latent period was 55 months, and showed poor mean survival period of 15 months. Radiotherapy seems to be a significant risk factor for the development of SM, but more cases are needed to assess the actual risk of certain chemotherapeutic agent. For this purpose, KSPHO continues to collect the cases of SM and to follow up the registered patients.
Alkylating Agents ; Anthracyclines ; Child ; Drug Therapy ; Etoposide ; Female ; Follow-Up Studies ; Humans ; Korea ; Neoplasms, Second Primary* ; Osteosarcoma ; Radiotherapy ; Retinoblastoma ; Risk Factors

Hodgkin's disease, manifested as a second malignant neoplasm in acute lymphoblastic leukemia, rarely occurs, with seventeen cases reported including this cases. We presented the clinical and pathological features of a nine-year-old male child with acute lymphoblastic leukemia in remission. He had cervical lymph node involvement 22 months after the diagnosis of leukemia as an initial presentation of Hodgkin's disease of mixed cellularity. A brief review of related literatures was also done.
Antineoplastic Agents/administration & dosage ; Case Report ; Child ; Hodgkin Disease/*complications/pathology ; Human ; Leukemia, Lymphocytic, Acute/*complications/drug therapy/pathology ; Male ; Neoplasms, Second Primary/pathology