Synchronous triple primary cancers of the pharynx and esophagus.
A 72-year-old male with nausea and heartburn was found to have early pharyngeal squamous cell carcinoma, superficial and advanced esophageal squamous cell carcinoma and early esophageal adenocarcinoma by esophagogastroduodenoscopy. Computerized tomography demonstrated left cardiac lymph node swellings. We prioritized the treatment for esophageal squamous cell carcinoma, as this was the most advanced cancer among the triple primaries. The patient underwent neoadjuvant chemotherapy for esophageal squamous cell carcinoma followed by esophagectomy. Four months after esophagectomy, endoscopic submucosal dissection for pharyngeal squamous cell carcinoma was performed. This is a first report of pharyngeal squamous cell carcinoma, esophageal squamous cell carcinoma and esophageal adenocarcinoma occurring as triple primary cancers in a single patient. Smoking-induced tumor formation through DNA methylation is a common risk factor for patients with triple primary malignancies, being an example of epigenetic field cancerization induced by exposure to carcinogenic factors.
Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-81-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Seita
S
Kataoka
Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-81-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan. masami.nego@jfcr.or.jp.
Masami
M
Omae
Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-81-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Yusuke
Y
Horiuchi
Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-81-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Akiyoshi
A
Ishiyama
Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-81-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Toshiyuki
T
Yoshio
Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-81-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Toshiaki
T
Hirasawa
Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-81-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Yorimasa
Y
Yamamoto
Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-81-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Tomohiro
T
Tsuchida
Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-81-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Junko
J
Fujisaki
Department of Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
Kazuhiko
K
Yamada
Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-81-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Masahiro
M
Igarashi
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D016629:Esophagectomy; D006801:Humans; D008297:Male; D020360:Neoadjuvant Therapy / Q000379:methods; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D010610:Pharyngeal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy
Early detection; Early esophageal adenocarcinoma; Early pharyngeal squamous cell carcinoma; Esophageal squamous cell carcinoma; Field epigenetic cancerization