title: Synchronous triple cancers at middle and lower esophagus and stomach with different histological features and genetic alterations.
abstract: Synchronous multiple primary malignancies are relatively unusual. We describe a case of synchronous triple cancers located at the middle and lower esophagus and the stomach in a 59-year-old Taiwanese man who presented with progressive dysphagia, epigastralgia, and bodyweight loss in 1 month. Endoscopic and histological features, microsatellite instability status of genomic DNA, and immunohistochemical staining of p53, MUC2, Fhit, c-erbB-2 and E-cadherin of all three cancers were demonstrated. We noted that these three cancers arose from different clones and that p53 mutation, instead of microsatellite instability, may play a major role in the development of multiple primary malignancies in this patient.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan.
authors.forename: Yu-Ting
authors.initials: YT
authors.lastname: Chang
authors.forename: Chun-I
authors.initials: CI
authors.lastname: Tsai
authors.forename: Tzeng-Huey
authors.initials: TH
authors.lastname: Yang
authors.forename: Chia-Wen
authors.initials: CW
authors.lastname: Shih
authors.forename: Ming-Shiang
authors.initials: MS
authors.lastname: Wu
authors.forename: Jaw-Town
authors.initials: JT
authors.lastname: Lin
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000235:genetics / Q000473:pathology*; D003937:Diagnosis, Differential; D004938:Esophageal Neoplasms / Q000235:genetics / Q000473:pathology*; D004945:Esophagoscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000235:genetics / Q000473:pathology*; D013274:Stomach Neoplasms / Q000235:genetics / Q000473:pathology*