title: Asymptomatic synchronous quintuple primary cancers.
abstract: We encountered a 46-year-old woman with synchronous quintuple primary cancers. She did not present with any symptoms, and her tumors were discovered at a gynecological screening. She had clear cell adenocarcinoma of the right ovary, moderately differentiated endometrioid adenocarcinoma of the endometrium, moderately differentiated adenocarcinoma of the ascending colon, well-differentiated adenocarcinoma of the rectum, and poorly differentiated papillary adenocarcinoma of the left lung. A fluorodeoxyglucose-positron emission tomography and other imaging techniques were extremely useful for the diagnosis of multiple primary cancers. Moreover, MSH2 protein expression was absent in the tumors of the ovary, endometrium, ascending colon, and rectum, while the rectal cancer also lacked MLH1 protein. These findings suggested that an abnormality of DNA mismatch repair genes was responsible for carcinogenesis.
authors: Department of Obstetrics and Gynecology, Fujita Health University School of Medicine, Toyoake, Japan. shinkomiyama@gmail.com
authors: Shinichi
authors: S
authors: Komiyama
authors: Eiji
authors: E
authors: Nishio
authors: Ryoko
authors: R
authors: Ichikawa
authors: Hironori
authors: H
authors: Miyamura
authors: Kyoko
authors: K
authors: Kawamura
authors: Mizuka
authors: M
authors: Komiyama
authors: Yoshimori
authors: Y
authors: Nishio
authors: Yasuhiro
authors: Y
authors: Udagawa
mesh_terms: D048868:Adaptor Proteins, Signal Transducing / Q000235:genetics; D000230:Adenocarcinoma / Q000175:diagnosis / Q000235:genetics / Q000628:therapy; D000231:Adenocarcinoma, Papillary / Q000175:diagnosis / Q000235:genetics / Q000628:therapy; D058070:Asymptomatic Diseases; D018269:Carcinoma, Endometrioid / Q000175:diagnosis / Q000235:genetics / Q000628:therapy; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000628:therapy; D053843:DNA Mismatch Repair; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000628:therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000628:therapy; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D000070957:MutL Protein Homolog 1; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000235:genetics* / Q000628:therapy; D009687:Nuclear Proteins / Q000235:genetics; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000628:therapy; D049268:Positron-Emission Tomography; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000628:therapy; D014057:Tomography, X-Ray Computed
chemical_list: D048868:Adaptor Proteins, Signal Transducing; C501486:MLH1 protein, human; D009687:Nuclear Proteins; D000070957:MutL Protein Homolog 1