title: Synchronous quadruple multiple primary cancers of the tongue, bilateral breasts, and kidney in a female patient with a disease-free survival time of more than 5 years: a case report.
abstract: BACKGROUND
  Reports of synchronous multiple primary cancers in patients with oral cancer have recently been increasing because of progress in radiographic diagnostic techniques. Multiple primary cancers in patients with oral cavity cancer mainly occur in the head and neck region, lung, and esophagus. 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography is usually used to identify synchronous multiple primary cancers.
  
  
  METHODS
  We herein describe a 69-year-old woman diagnosed with synchronous quadruple multiple primary cancers, namely a squamous cell carcinoma of the mobile tongue, invasive ductal carcinoma of the right breast, intraductal carcinoma of the left breast, and chromophobe renal cell carcinoma of the right kidney. We removed the four tumors over three surgical procedures to reduce the surgical risk because the patient had diabetes mellitus. To the best of our knowledge, this combination of multiple primary cancers has not been reported to date. Importantly, we followed this case for 5 years after surgery. The patient was alive and well with no clinical or radiologic signs of recurrent or metastatic disease at the time of this writing.
  
  
  CONCLUSIONS
  In the present case, the kidney cancer could not be detected by 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography but could be detected by contrast-enhanced computed tomography. To avoid overlooking multiple primary cancers of the kidney, we suggest that contrast-enhanced computed tomography should cover a region extending to the inferior margin of the kidney, rather than only to the liver, in patients with oral cavity cancer.
authors: Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan. h075324@eve.u-ryukyu.ac.jp.|Department of Oral and Maxillofacial Surgery, University Hospital of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan. h075324@eve.u-ryukyu.ac.jp.
authors: Tessho
authors: T
authors: Maruyama
authors: Department of Oral and Maxillofacial Surgery, University Hospital of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan. t-nakasone@par.odn.ne.jp.
authors: Toshiyuki
authors: T
authors: Nakasone
authors: Departments of Dentistry and Oral Surgery, Chubu Tokushukai Hospital, 3-20-1, Teruya, Okinawa, 904-8585, Japan. nobun6397@gmail.com.
authors: Nobuyuki
authors: N
authors: Maruyama
authors: Department of Oral and Maxillofacial Surgery, University Hospital of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan. b983062@med.u-ryukyu.ac.jp.
authors: Akira
authors: A
authors: Matayoshi
authors: Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan. arasaki@med.u-ryukyu.ac.jp.|Department of Oral and Maxillofacial Surgery, University Hospital of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan. arasaki@med.u-ryukyu.ac.jp.
authors: Akira
authors: A
authors: Arasaki
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D002292:Carcinoma, Renal Cell / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D015996:Survival Rate; D014062:Tongue Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery