Primary multiple cancer in practice of urological oncologist

Primary multiple malignancies (PMMs) are defined as two or more malignant tumors of various pathogenic origin detected simultaneously or sequentially in one patient. Despite the successes of modern medicine, the incidence of PMMs is steadily increasing. According to worldwide statistics, the inciden...

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Main Authors: M. D. Ter-Ovanesov, D. M. Yagudaev, A. A. Gritskevich, E. V. Anikanova, K. I. Medvedev
Format: Article
Language:Russian
Published: QUASAR, LLC 2024-06-01
Series:Исследования и практика в медицине
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Online Access:https://www.rpmj.ru/rpmj/article/view/917
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author M. D. Ter-Ovanesov
D. M. Yagudaev
A. A. Gritskevich
E. V. Anikanova
K. I. Medvedev
author_facet M. D. Ter-Ovanesov
D. M. Yagudaev
A. A. Gritskevich
E. V. Anikanova
K. I. Medvedev
author_sort M. D. Ter-Ovanesov
collection DOAJ
description Primary multiple malignancies (PMMs) are defined as two or more malignant tumors of various pathogenic origin detected simultaneously or sequentially in one patient. Despite the successes of modern medicine, the incidence of PMMs is steadily increasing. According to worldwide statistics, the incidence of PMMs in the oncological population has increased from 2.4 to 8.0 % over the course of the 20 year span. The number of patients with PMMs is also increasing in the Russian Federation. Total of 58,217 PMMs were detected for the first time in our country in 2021, which constitutes 10.0 % of all newly diagnosed malignant neoplasms. Two tumors are usually observed among patients with PMMs (in 84–100 % of patients), three tumors occur in 9.9–16.0 % of these patients, four in 1.62 %, and five or more occur in only 0.095 %.Currently, the pathogenesis of this condition has not yet been fully studied. There are hypotheses that endogenous, exogenous, hereditary, and therapeutic factors are involved in the occurrence of PMMs. Endogenous factors include immunologic status, endocrine factors, and hereditary predisposition. Exogenous factors are represented by lifestyle and environmental factors such as smoking and alcohol, low physical activity, as well as prolonged exposure to ultraviolet radiation and industrial pollution. Iatrogenic factors, including radiation therapy and chemotherapy, can also increase the risk of developing PMMs.This article represents a clinical case of a patient born in 1942, in whom, during 11 years of follow-up care, primary multiple synchronous metachronous cancers of 5 localizations and 4 histological types were verified and treated. The presented clinical case is interesting for a very rare number of neoplasms and a relatively high duration of follow-up period. The authors describe in detail each stage, the choice of diagnostic methods and the definition of treatment tactics with an assessment of the accuracy of clinical decision-making.
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spelling doaj-art-be90b31073844a2aa2e7cf982178970b2025-02-03T07:12:18ZrusQUASAR, LLCИсследования и практика в медицине2410-18932024-06-0111289100541Primary multiple cancer in practice of urological oncologistM. D. Ter-Ovanesov0D. M. Yagudaev1A. A. Gritskevich2E. V. Anikanova3K. I. Medvedev4Central Clinical Hospital «RZhD-Medicine»; <p> A. I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of the Russian Federation<p> Moscow, Russian FederationCentral Clinical Hospital «RZhD-Medicine»;<p> Peoples Friendship University of Russia (RUDN University)<p> Moscow, Russian FederationA. V. Vishnevsky National Medical Research Center of Surgery of the Ministry of Healthcare of the Russian Federation <p> Peoples Friendship University of Russia (RUDN University)<p> Moscow, Russian FederationCentral Clinical Hospital «RZhD-Medicine»; <p> A. I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of the Russian Federation<p> Moscow, Russian FederationA. I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of the Russian Federation<p> Moscow, Russian FederationPrimary multiple malignancies (PMMs) are defined as two or more malignant tumors of various pathogenic origin detected simultaneously or sequentially in one patient. Despite the successes of modern medicine, the incidence of PMMs is steadily increasing. According to worldwide statistics, the incidence of PMMs in the oncological population has increased from 2.4 to 8.0 % over the course of the 20 year span. The number of patients with PMMs is also increasing in the Russian Federation. Total of 58,217 PMMs were detected for the first time in our country in 2021, which constitutes 10.0 % of all newly diagnosed malignant neoplasms. Two tumors are usually observed among patients with PMMs (in 84–100 % of patients), three tumors occur in 9.9–16.0 % of these patients, four in 1.62 %, and five or more occur in only 0.095 %.Currently, the pathogenesis of this condition has not yet been fully studied. There are hypotheses that endogenous, exogenous, hereditary, and therapeutic factors are involved in the occurrence of PMMs. Endogenous factors include immunologic status, endocrine factors, and hereditary predisposition. Exogenous factors are represented by lifestyle and environmental factors such as smoking and alcohol, low physical activity, as well as prolonged exposure to ultraviolet radiation and industrial pollution. Iatrogenic factors, including radiation therapy and chemotherapy, can also increase the risk of developing PMMs.This article represents a clinical case of a patient born in 1942, in whom, during 11 years of follow-up care, primary multiple synchronous metachronous cancers of 5 localizations and 4 histological types were verified and treated. The presented clinical case is interesting for a very rare number of neoplasms and a relatively high duration of follow-up period. The authors describe in detail each stage, the choice of diagnostic methods and the definition of treatment tactics with an assessment of the accuracy of clinical decision-making.https://www.rpmj.ru/rpmj/article/view/917multiple primary malignanciesprimary multiple synchronous cancerprimary multiple metachronous cancerurothelial cancerprostate cancerrenal cell carcinomagastric cancerclinical case
spellingShingle M. D. Ter-Ovanesov
D. M. Yagudaev
A. A. Gritskevich
E. V. Anikanova
K. I. Medvedev
Primary multiple cancer in practice of urological oncologist
Исследования и практика в медицине
multiple primary malignancies
primary multiple synchronous cancer
primary multiple metachronous cancer
urothelial cancer
prostate cancer
renal cell carcinoma
gastric cancer
clinical case
title Primary multiple cancer in practice of urological oncologist
title_full Primary multiple cancer in practice of urological oncologist
title_fullStr Primary multiple cancer in practice of urological oncologist
title_full_unstemmed Primary multiple cancer in practice of urological oncologist
title_short Primary multiple cancer in practice of urological oncologist
title_sort primary multiple cancer in practice of urological oncologist
topic multiple primary malignancies
primary multiple synchronous cancer
primary multiple metachronous cancer
urothelial cancer
prostate cancer
renal cell carcinoma
gastric cancer
clinical case
url https://www.rpmj.ru/rpmj/article/view/917
work_keys_str_mv AT mdterovanesov primarymultiplecancerinpracticeofurologicaloncologist
AT dmyagudaev primarymultiplecancerinpracticeofurologicaloncologist
AT aagritskevich primarymultiplecancerinpracticeofurologicaloncologist
AT evanikanova primarymultiplecancerinpracticeofurologicaloncologist
AT kimedvedev primarymultiplecancerinpracticeofurologicaloncologist