Hepatitis C virus: a high risk factor for a second primary malignancy besides hepatocellular carcinoma. Fact or fiction?
OBJECTIVE
Second primary malignancies occur more and more often. But the hepatocellular carcinoma (HCC) linked to a second primary cancer is not frequent.


METHODS
A retrospective study focused on a second primary cancer was performed in 37 patients with HCC, aged between 46 and 81 years, 27 males and 10 females.


RESULTS
5 out of them (13.5%), 3 males and 2 females, developed a second primary neoplasm before or after HCC. In 3 cases the second malignancy was a carcinoma of the kidney, of the breast, and the prostate. The fourth patient had a Hodgkin's lymphoma before HCC. The last and most unlucky case, besides HCC, had a basal cell carcinoma, a colorectal cancer, and a bladder carcinoma. The common data of these 5 patients were the presence of anti-HCV antibodies and the positivity of the HCV RNA polymerase reaction. One patient was also HBV positive.


CONCLUSIONS
Considering that a large number of virus has been found linked to human cancers, our results brought us to hypothesize that HCV could have played an important role not only in the development of HCC but of the second primary malignancy too. This is likely favoured by constitutional or acquired biological and molecular alterations. Tumor suppressor genes alterations have been reported to be frequently linked to cancers of kidney and breast, of colorectal and skin, of prostate, and lymphoemopoietic tissue. Now just these organs are involved in our patients in addition to the liver. Our results, if confirmed, are of a relevant interest, considering that world-wide HCC is constantly increasing for the spreading of the virus risk-factors.
Bruno
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G
Istituto I Clinica Medica, Fondazione A. Cesalpino, Università di Roma La Sapienza, Italy.
Andreozzi
P
P
Graf
U
U
Santangelo
G
G
D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000821:virology; D006528:Carcinoma, Hepatocellular / Q000821:virology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000821:virology; D008103:Liver Cirrhosis / Q000821:virology; D008113:Liver Neoplasms / Q000821:virology*; D008228:Lymphoma, Non-Hodgkin / Q000821:virology; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000821:virology*; D011471:Prostatic Neoplasms / Q000821:virology; D012189:Retrospective Studies; D012307:Risk Factors