Heterochronic triple primary malignancies with Epstein-Barr virus infection and tumor protein 53 gene mutation:A case report and review of literature  

作　　者：Wen-Xia Peng Xin Liu Qi-Feng Wang Xiao-Yan Zhou Zhi-Guo Luo Xi-Chun Hu 

机构地区：[1]Department of Medical Oncology,Fudan University Shanghai Cancer Center,Shanghai 200032,China [2]Department of Pathology,Fudan University Shanghai Cancer Center,Shanghai 200032,China

出　　处：《World Journal of Clinical Cases》2021年第5期1184-1195,共12页世界临床病例杂志

摘　　要：BACKGROUND The diagnosis and etiology of multiple primary malignant neoplasms(MPMNs)are difficult to establish.Here,we report a case of heterochronic triple primary malignancies with gastric cancer,nasopharyngeal squamous cell cancer,and then rectal cancer.CASE SUMMARY The patient was first diagnosed with gastric cancer at the age of 33 in 2014 and underwent distal gastrectomy and gastrojejunostomy and six cycles of adjuvant chemotherapy.Three years later,he was diagnosed with nasopharyngeal cancer and treated with radical chemoradiotherapy in 2017.Recently,a mass in the middle of the rectum was resected and reported as ulcerative,moderately to poorly differentiated adenocarcinoma.Research on the etiology of MPMNs showed that Epstein-Barr virus(EBV)infection may be the cause of gastric cancer and nasopharyngeal squamous cell cancer since these two primary lesions were positive for transcripts of EBV-encoded ribonucleic acid using an in situ hybridization EBV-encoded ribonucleic acid probe in formalin-fixed,paraffinembedded tissue.The cause of rectal cancer may be due to a somatic mutation of tumor protein 53 gene in exon 8(c.844C>T,p.Arg282Trp)through highthroughput sequencing for the rectal cancer.Appropriate standard therapy for each primary cancer was administered,and the patient has no evidence of cancer disease to date.CONCLUSION To our knowledge,this is the first report on heterochronic triple primary malignancies whose cause may be associated with EBV infection and tumor protein 53 genetic mutations.The etiological research may not only elucidate the cause of MPMN but also has implications in clinical management.

关 键 词：Multiple primary malignant neoplasms Epstein-Barr virus infection Epstein-Barr virus-encoded RNA TP53 mutation ETIOLOGY Case report 

分 类 号：R735.2[医药卫生—肿瘤] R739.63[医药卫生—临床医学] R735.37