Gastrointestinal cancer educational case series: management of metastatic adenocarcinoma of unknown primary origin in a Ph+ ALL survivor.
BACKGROUND
Secondary malignancies and chronic end-organ sequelae are significant and steadily rising consequences of cancer therapy. The workup and management of a carcinoma of unknown primary must consider the patient's clinical presentation, radiologic and pathologic findings, and comorbidities.


METHODS
We present the case of a 50-year-old female survivor of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) with significant treatment-related end-organ sequelae who developed a metastatic adenocarcinoma of unknown primary 15 years following curative therapy for her ALL. The complex management issues related to the investigations and choice of therapy for this patient are reviewed.


CONCLUSIONS
This case discusses key issues related to the workup and management of a carcinoma of unknown primary. In addition, it illustrates the importance of taking patient comorbidities into consideration and tailoring investigations and therapy accordingly.
Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
Celina
C
Ang
Eileen M
EM
O'Reilly
Ghassan K
GK
Abou-Alfa
Ali
A
Shamseddine
Hadi
H
Skouri
Ayman
A
Tawil
Mohamad A
MA
Eloubeidi
Maeve
M
Lowery
Mohamed
M
Kharfan-Dabaja
Tania
T
Kaprealian
Sally
S
Temraz
Hassan
H
Sibai
Hassan
H
Farran
Manish A
MA
Shah
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000188:drug therapy* / Q000473:pathology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000473:pathology*; D017741:Survivors; D016896:Treatment Outcome