title: Multiple synchronous primaries of the gastrointestinal tract: a molecular case report.
abstract: Six synchronous gastrointestinal primaries were identified in a 70 year old male with no known cancer predisposition syndrome or recognized risk factors except alcohol abuse. These specimens appeared to be independent and unrelated by gross and histopathological examination. In order to further evaluate the six tumors, we analyzed selected DNA sequences for alterations in the K-ras oncogene and p53 tumor suppressor gene. In addition, three loci were analyzed to determine microsatellite instability. Using the polymerase chain reaction, single stranded conformational polymorphism, and DNA sequencing, we demonstrated that each primary manifests genetic characteristics typical of the tissue of origin. In addition, one primary, a moderately differentiated colon adenocarcinoma, exhibited mutations not detected in the other specimens. This study suggests that these synchronous primaries arose independently and progressed along different carcinogenic pathways.
authors.affiliation: Department of Biochemistry, Veterans Affairs Medical Center, Jackson, MS 39216, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Herring
authors.forename: U
authors.initials: U
authors.lastname: Shivangi
authors.forename: C C
authors.initials: CC
authors.lastname: Hall
authors.forename: A A
authors.initials: AA
authors.lastname: Mihas
authors.forename: C
authors.initials: C
authors.lastname: Lynch
authors.forename: N
authors.initials: N
authors.lastname: Vijay-Munshi
authors.forename: T J
authors.initials: TJ
authors.lastname: Hall
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics* / Q000473:pathology; D000368:Aged; D003062:Codon / Q000235:genetics; D003110:Colonic Neoplasms / Q000235:genetics* / Q000473:pathology; D003111:Colonic Polyps / Q000235:genetics / Q000473:pathology; D005091:Exons / Q000235:genetics; D016158:Genes, p53 / Q000235:genetics*; D011905:Genes, ras / Q000235:genetics*; D006801:Humans; D007417:Intestinal Polyps / Q000235:genetics* / Q000473:pathology; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000235:genetics* / Q000473:pathology; D012004:Rectal Neoplasms / Q000235:genetics* / Q000473:pathology; D013274:Stomach Neoplasms / Q000235:genetics* / Q000473:pathology
chemical_list: D003062:Codon