A rare case of synchronous multiple primary malignancies of breast cancer and diffuse large B-cell lymphoma that responded to multidisciplinary treatment: a case report

Abstract Background Multiple primary malignancies of breast cancer and diffuse large B-cell lymphoma (DLBCL) are rare. Here, we report a case of advanced breast cancer and DLBCL managed with multidisciplinary therapy preceded by surgery with a successful outcome. Case presentation During a medical e...

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Main Authors: Yuichi Ueda, Yuko Makino, Taro Tochigi, Yoshikazu Ota, Hideki Hidaka, Takeshi Nakamura, Kiichiro Beppu, Jiro Ohuchida, Seiichi Odate, Soshi Terasaka, Takahiro Nishida, Masaki Yoshida, Ryuichiro Kimura, Kousuke Marutsuka, Naoki Otomo
Format: Article
Language:English
Published: Japan Surgical Society 2022-05-01
Series:Surgical Case Reports
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Online Access:https://doi.org/10.1186/s40792-022-01456-z
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author Yuichi Ueda
Yuko Makino
Taro Tochigi
Yoshikazu Ota
Hideki Hidaka
Takeshi Nakamura
Kiichiro Beppu
Jiro Ohuchida
Seiichi Odate
Soshi Terasaka
Takahiro Nishida
Masaki Yoshida
Ryuichiro Kimura
Kousuke Marutsuka
Naoki Otomo
author_facet Yuichi Ueda
Yuko Makino
Taro Tochigi
Yoshikazu Ota
Hideki Hidaka
Takeshi Nakamura
Kiichiro Beppu
Jiro Ohuchida
Seiichi Odate
Soshi Terasaka
Takahiro Nishida
Masaki Yoshida
Ryuichiro Kimura
Kousuke Marutsuka
Naoki Otomo
author_sort Yuichi Ueda
collection DOAJ
description Abstract Background Multiple primary malignancies of breast cancer and diffuse large B-cell lymphoma (DLBCL) are rare. Here, we report a case of advanced breast cancer and DLBCL managed with multidisciplinary therapy preceded by surgery with a successful outcome. Case presentation During a medical examination, a 71-year-old woman was diagnosed with a right breast mass, enlarged lymph nodes throughout the body, and a splenic tumor. The results of the clinical examination and imaging were suggestive of widely spread breast cancer with lymph node metastasis and malignant lymphoma with systemic metastasis. The histological evaluation of the biopsied breast tissue revealed human epidermal growth factor receptor 2 (HER2)-positive breast cancer, whereas the histological evaluation of the excised inguinal lymph node revealed DLBCL. 18F-FDG PET/computed tomography was performed, and it was determined that both breast cancer and DLBCL were in an advanced stage. Thus, mastectomy was performed, and the axillary lymph nodes showed mixed metastasis of breast cancer and DLBCL. Soon after, the R-CHOP therapy was initiated (375-mg/m2 rituximab, 2-mg/m2 vincristine, 50-mg/m2 doxorubicin, 750-mg/m2 cyclophosphamide, and 125-mg methylprednisolone). After irradiation of the spleen, trastuzumab was administered for 1 year. Conclusions We experienced a case of combined breast cancer and DLBCL, which was difficult to treat because both were in advanced stages. Thorough staging of the malignancy and discussion by a multidisciplinary team are necessary to determine the optimal treatment strategy.
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spelling doaj-art-2bfc09f386c84c4889f8425cacf5c5992025-08-20T02:37:28ZengJapan Surgical SocietySurgical Case Reports2198-77932022-05-01811710.1186/s40792-022-01456-zA rare case of synchronous multiple primary malignancies of breast cancer and diffuse large B-cell lymphoma that responded to multidisciplinary treatment: a case reportYuichi Ueda0Yuko Makino1Taro Tochigi2Yoshikazu Ota3Hideki Hidaka4Takeshi Nakamura5Kiichiro Beppu6Jiro Ohuchida7Seiichi Odate8Soshi Terasaka9Takahiro Nishida10Masaki Yoshida11Ryuichiro Kimura12Kousuke Marutsuka13Naoki Otomo14Department of Surgery, Miyazaki Prefectural Miyazaki HospitalDepartment of Surgery, Miyazaki Prefectural Miyazaki HospitalDepartment of Internal Medicine, Miyazaki Prefectural Miyazaki HospitalMedical City Tobu HospitalDepartment of Surgery, Miyazaki Prefectural Miyazaki HospitalDepartment of Surgery, Miyazaki Prefectural Miyazaki HospitalDepartment of Surgery, Miyazaki Prefectural Miyazaki HospitalDepartment of Surgery, Miyazaki Prefectural Miyazaki HospitalDepartment of Surgery, Miyazaki Prefectural Miyazaki HospitalDepartment of Surgery, Miyazaki Prefectural Miyazaki HospitalDepartment of Surgery, Miyazaki Prefectural Miyazaki HospitalDepartment of Surgery, Miyazaki Prefectural Miyazaki HospitalDepartment of Surgery, Miyazaki Prefectural Miyazaki HospitalDepartment of Diagnostic Pathology, Miyazaki Prefectural Miyazaki HospitalDepartment of Surgery, Miyazaki Prefectural Miyazaki HospitalAbstract Background Multiple primary malignancies of breast cancer and diffuse large B-cell lymphoma (DLBCL) are rare. Here, we report a case of advanced breast cancer and DLBCL managed with multidisciplinary therapy preceded by surgery with a successful outcome. Case presentation During a medical examination, a 71-year-old woman was diagnosed with a right breast mass, enlarged lymph nodes throughout the body, and a splenic tumor. The results of the clinical examination and imaging were suggestive of widely spread breast cancer with lymph node metastasis and malignant lymphoma with systemic metastasis. The histological evaluation of the biopsied breast tissue revealed human epidermal growth factor receptor 2 (HER2)-positive breast cancer, whereas the histological evaluation of the excised inguinal lymph node revealed DLBCL. 18F-FDG PET/computed tomography was performed, and it was determined that both breast cancer and DLBCL were in an advanced stage. Thus, mastectomy was performed, and the axillary lymph nodes showed mixed metastasis of breast cancer and DLBCL. Soon after, the R-CHOP therapy was initiated (375-mg/m2 rituximab, 2-mg/m2 vincristine, 50-mg/m2 doxorubicin, 750-mg/m2 cyclophosphamide, and 125-mg methylprednisolone). After irradiation of the spleen, trastuzumab was administered for 1 year. Conclusions We experienced a case of combined breast cancer and DLBCL, which was difficult to treat because both were in advanced stages. Thorough staging of the malignancy and discussion by a multidisciplinary team are necessary to determine the optimal treatment strategy.https://doi.org/10.1186/s40792-022-01456-zMultiple primary malignanciesDouble cancerSynchronousBreast cancerDLBCL
spellingShingle Yuichi Ueda
Yuko Makino
Taro Tochigi
Yoshikazu Ota
Hideki Hidaka
Takeshi Nakamura
Kiichiro Beppu
Jiro Ohuchida
Seiichi Odate
Soshi Terasaka
Takahiro Nishida
Masaki Yoshida
Ryuichiro Kimura
Kousuke Marutsuka
Naoki Otomo
A rare case of synchronous multiple primary malignancies of breast cancer and diffuse large B-cell lymphoma that responded to multidisciplinary treatment: a case report
Surgical Case Reports
Multiple primary malignancies
Double cancer
Synchronous
Breast cancer
DLBCL
title A rare case of synchronous multiple primary malignancies of breast cancer and diffuse large B-cell lymphoma that responded to multidisciplinary treatment: a case report
title_full A rare case of synchronous multiple primary malignancies of breast cancer and diffuse large B-cell lymphoma that responded to multidisciplinary treatment: a case report
title_fullStr A rare case of synchronous multiple primary malignancies of breast cancer and diffuse large B-cell lymphoma that responded to multidisciplinary treatment: a case report
title_full_unstemmed A rare case of synchronous multiple primary malignancies of breast cancer and diffuse large B-cell lymphoma that responded to multidisciplinary treatment: a case report
title_short A rare case of synchronous multiple primary malignancies of breast cancer and diffuse large B-cell lymphoma that responded to multidisciplinary treatment: a case report
title_sort rare case of synchronous multiple primary malignancies of breast cancer and diffuse large b cell lymphoma that responded to multidisciplinary treatment a case report
topic Multiple primary malignancies
Double cancer
Synchronous
Breast cancer
DLBCL
url https://doi.org/10.1186/s40792-022-01456-z
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