Multiple primary malignancies

Our plain-English summary of Multiple primary malignancies, by R.S. Hoffman, A.H. Rossof, R. Pazdur, et al (Journal of Clinical Oncology, 1984).

The study

• Authors: R.S. Hoffman, A.H. Rossof, R. Pazdur, R.E. Slayton
• Journal: Journal of Clinical Oncology
• Published: 1984;2(11):1305
• Type of article: Case report, Letter
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

In this letter, the authors responded to a report by Antman et al of malignant mesothelioma after radiation exposure by describing one further case from their own practice in Chicago. In 1955, a 33-year-old man had surgery for a left testicular seminoma and received prophylactic radiation therapy to the para-aortic and mediastinal lymph node areas. The exact dose was unknown, but the local radiation therapist estimated it at 25 to 30 Gy. The man later developed a basal cell carcinoma of the cheek in 1972, treated with radiation, and a left shoulder tumor in 1974-1975, eventually diagnosed as malignant fibrous histiocytoma. In late 1979, a right-sided pleural effusion developed, and bilateral pleural malignant mesothelioma of epithelial type was diagnosed at thoracotomy, 24 years after the radiation for seminoma. He was treated with chemotherapy and further radiation and died about two months after starting cyclophosphamide. Autopsy found a previously unknown renal cell carcinoma with metastases. There was no history of asbestos exposure and no autopsy evidence of it. The authors noted that the latent period was similar to that reported for other radiation-associated tumors. They suggested that defects of DNA repair or immune factors were also possible, given his multiple primary cancers. They concluded that malignant mesothelioma without evidence of asbestos exposure should be considered among radiation-induced neoplasms.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This was a letter to the editor describing one patient. It responded to an earlier article by Antman and colleagues on malignant mesothelioma after radiation exposure. In 1955, at age 33, the patient had surgery for testicular seminoma and then six weeks of radiation therapy to lymph node areas in the abdomen and chest. The exact dose was not recorded; a local radiation therapist estimated it at 25 to 30 Gy. The patient later had a basal cell carcinoma of the cheek, also treated with radiation, and a malignant fibrous histiocytoma of the shoulder. Bilateral pleural malignant mesothelioma, epithelial type, was diagnosed 24 years after the radiation for seminoma. The patient received chemotherapy and further radiation and later died. At autopsy, a previously unknown renal cell carcinoma was found. The authors found no history of asbestos exposure and no autopsy evidence of it. They said other causes, such as defects of DNA repair or immune factors, were possible. The authors concluded that malignant mesothelioma without evidence of asbestos exposure should be considered among the cancers that radiation can induce.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (letter to the editor)
• Who was studied: one man treated at Rush-Presbyterian-St Luke's Medical Center, Chicago, first seen in 1955 at age 33 with left testicular seminoma
• Exposure: radiation therapy to para-aortic and mediastinal lymph node areas over six weeks in 1955, estimated at 25 to 30 Gy; no history or autopsy evidence of asbestos exposure
• Main results:
  • The patient developed bilateral pleural malignant mesothelioma, epithelial type, 24 years after radiation therapy for seminoma
  • Before the mesothelioma, the patient had a malignant fibrous histiocytoma with involved lymph nodes
  • Neither a history of asbestos exposure nor autopsy evidence of such exposure was found
  • At autopsy, a previously unknown renal cell carcinoma of the right kidney was found, spread to other organs
  • The patient died after chemotherapy and further radiation, from disseminated intravascular coagulation, adult respiratory distress syndrome, and renal failure
• The authors' conclusion: The authors concluded that radiation can induce various cancers and that malignant mesothelioma without evidence of asbestos exposure should be considered in this group
• Limitations the authors state:
  • The exact amount and type of radiation given was unknown and was only estimated
  • Other causes, such as defects of DNA repair or immune factors, were possible because the patient had multiple primary cancers

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Carcinoma, Pleural Effusion, Bilateral, Thoracotomy, Chemotherapy, Autopsy, Asbestos Exposure.

Related studies

• Malignant peritoneal mesothelioma following radiotherapy for seminoma of the testis — R.J. Stock, Y.S. Fu, et al. (1979)
• Asbestos exposure and multiple primary tumors — V.A. Dohner, R.G. Beegle, et al. (1975)
• Malignant (Diffuse) Mesothelioma in Patients With Hematologic Malignancies: A Clinicopathologic Study of 45 Cases — X. Li, N.A. Brownlee, et al. (2015)
• Minute localized malignant pleural mesothelioma coexisting with multiple adenocarcinomas — R. Maeda, N. Isowa, et al. (2010)
• Sudden death of an elderly man with multiple malignant neoplasms — L.R. Boglioli, M.L. Taff, et al. (1991)
• Malignant mesothelioma of the pleura and other malignancies in the same patient — C. Bianchi, T. Bianchi, et al. (2007)

Browse more research in Journal of Clinical Oncology, or return to medical research.