Multiple Rare Primary Malignancies: A Mixed Squamous Neuroendocrine Adenocarcinoma of the Cervix, Metastasized Carcinosarcoma and Extramammary Vulvar Paget’s Disease Case Report
The occurrence of more than one primary malignant tumor in a single patient is rare. Multiple primary malignancies can pose difficulties in differential diagnosis between primary tumors and metastasis. Here, we present a case report with multiple primary malignancies. The patient is a 45-year-old fe...
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MDPI AG
2023-05-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/5/995 |
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| author | Linas Andreika Karolina Vankevičienė Marija Plioplytė Monika Bitinaitytė Vilius Rudaitis |
| author_facet | Linas Andreika Karolina Vankevičienė Marija Plioplytė Monika Bitinaitytė Vilius Rudaitis |
| author_sort | Linas Andreika |
| collection | DOAJ |
| description | The occurrence of more than one primary malignant tumor in a single patient is rare. Multiple primary malignancies can pose difficulties in differential diagnosis between primary tumors and metastasis. Here, we present a case report with multiple primary malignancies. The patient is a 45-year-old female who was diagnosed with cervical mixed squamous neuroendocrine adenocarcinoma, metastasized carcinosarcoma and extramammary vulvar Paget’s disease. The patient was first diagnosed with a microinvasive squamous cervical carcinoma in situ. After a few months, the amputation of a small residual tumor and histological evaluation revealed an IA1-stage poorly differentiated (G3) mixed squamous and neuroendocrine cervical adenocarcinoma. After two years, the disease had progressed and biopsies from altered sites were taken. Histological diagnosis from an ulcerated vulvar region revealed extramammary vulvar Paget’s disease. A biopsy from vagina polyp revealed an earlier diagnosed mixed squamous and neuroendocrine cervical adenocarcinoma. However, histological diagnosis from an inguinal lymph node biopsy was unexpected and revealed carcinosarcoma. It indicated either the development of another primary malignancy, or an unusual spread of metastasis. Clinical presentation as well as diagnostic and treatment challenges are discussed in this case report. This case report shows that multiple primary malignancy cases are difficult to manage both for clinicians and the patient because the therapeutic options can become limited. This complex case was managed by a multidisciplinary team. |
| first_indexed | 2024-03-11T03:30:12Z |
| format | Article |
| id | doaj.art-3e4aa94953f54d25a35a0b3e6718e655 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-11T03:30:12Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
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| series | Medicina |
| spelling | doaj.art-3e4aa94953f54d25a35a0b3e6718e6552023-11-18T02:23:25ZengMDPI AGMedicina1010-660X1648-91442023-05-0159599510.3390/medicina59050995Multiple Rare Primary Malignancies: A Mixed Squamous Neuroendocrine Adenocarcinoma of the Cervix, Metastasized Carcinosarcoma and Extramammary Vulvar Paget’s Disease Case ReportLinas Andreika0Karolina Vankevičienė1Marija Plioplytė2Monika Bitinaitytė3Vilius Rudaitis4Clinic of Obstetrics and Gynaecology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Čiurlionio Str. 21/27, LT-03101 Vilnius, LithuaniaFaculty of Medicine, Vilnius University, M. K. Čiurlionio Str. 21/27, LT-03101 Vilnius, LithuaniaFaculty of Medicine, Lithuanian University of Health Sciences, A.Mickevičiaus Str. 9, LT-44307 Kaunas, LithuaniaFaculty of Medicine, Lithuanian University of Health Sciences, A.Mickevičiaus Str. 9, LT-44307 Kaunas, LithuaniaClinic of Obstetrics and Gynaecology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Čiurlionio Str. 21/27, LT-03101 Vilnius, LithuaniaThe occurrence of more than one primary malignant tumor in a single patient is rare. Multiple primary malignancies can pose difficulties in differential diagnosis between primary tumors and metastasis. Here, we present a case report with multiple primary malignancies. The patient is a 45-year-old female who was diagnosed with cervical mixed squamous neuroendocrine adenocarcinoma, metastasized carcinosarcoma and extramammary vulvar Paget’s disease. The patient was first diagnosed with a microinvasive squamous cervical carcinoma in situ. After a few months, the amputation of a small residual tumor and histological evaluation revealed an IA1-stage poorly differentiated (G3) mixed squamous and neuroendocrine cervical adenocarcinoma. After two years, the disease had progressed and biopsies from altered sites were taken. Histological diagnosis from an ulcerated vulvar region revealed extramammary vulvar Paget’s disease. A biopsy from vagina polyp revealed an earlier diagnosed mixed squamous and neuroendocrine cervical adenocarcinoma. However, histological diagnosis from an inguinal lymph node biopsy was unexpected and revealed carcinosarcoma. It indicated either the development of another primary malignancy, or an unusual spread of metastasis. Clinical presentation as well as diagnostic and treatment challenges are discussed in this case report. This case report shows that multiple primary malignancy cases are difficult to manage both for clinicians and the patient because the therapeutic options can become limited. This complex case was managed by a multidisciplinary team.https://www.mdpi.com/1648-9144/59/5/995carcinosarcomaextramammary vulvar Paget’s diseasemultiple primary malignanciesMüllerian carcinosarcomaMalignant Mixed Müllerian Tumorneuroendocrine adenocarcinoma |
| spellingShingle | Linas Andreika Karolina Vankevičienė Marija Plioplytė Monika Bitinaitytė Vilius Rudaitis Multiple Rare Primary Malignancies: A Mixed Squamous Neuroendocrine Adenocarcinoma of the Cervix, Metastasized Carcinosarcoma and Extramammary Vulvar Paget’s Disease Case Report Medicina carcinosarcoma extramammary vulvar Paget’s disease multiple primary malignancies Müllerian carcinosarcoma Malignant Mixed Müllerian Tumor neuroendocrine adenocarcinoma |
| title | Multiple Rare Primary Malignancies: A Mixed Squamous Neuroendocrine Adenocarcinoma of the Cervix, Metastasized Carcinosarcoma and Extramammary Vulvar Paget’s Disease Case Report |
| title_full | Multiple Rare Primary Malignancies: A Mixed Squamous Neuroendocrine Adenocarcinoma of the Cervix, Metastasized Carcinosarcoma and Extramammary Vulvar Paget’s Disease Case Report |
| title_fullStr | Multiple Rare Primary Malignancies: A Mixed Squamous Neuroendocrine Adenocarcinoma of the Cervix, Metastasized Carcinosarcoma and Extramammary Vulvar Paget’s Disease Case Report |
| title_full_unstemmed | Multiple Rare Primary Malignancies: A Mixed Squamous Neuroendocrine Adenocarcinoma of the Cervix, Metastasized Carcinosarcoma and Extramammary Vulvar Paget’s Disease Case Report |
| title_short | Multiple Rare Primary Malignancies: A Mixed Squamous Neuroendocrine Adenocarcinoma of the Cervix, Metastasized Carcinosarcoma and Extramammary Vulvar Paget’s Disease Case Report |
| title_sort | multiple rare primary malignancies a mixed squamous neuroendocrine adenocarcinoma of the cervix metastasized carcinosarcoma and extramammary vulvar paget s disease case report |
| topic | carcinosarcoma extramammary vulvar Paget’s disease multiple primary malignancies Müllerian carcinosarcoma Malignant Mixed Müllerian Tumor neuroendocrine adenocarcinoma |
| url | https://www.mdpi.com/1648-9144/59/5/995 |
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