GASTROINTESTINAL AND ABDOMINAL RADIOLOGY / ORIGINAL PAPER
Synchronous tumours detected during cancer patient staging: prevalence and patterns of occurrence in multidetector computed tomography
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1
Motor Science and Wellness Department, University of Naples, Naples, Italy
2
Radiology Department, National Cancer Institute Pascale Foundation, Naples, Italy
3
Vascular and Interventional Radiology Department, Cardarelli Hospital, Naples, Italy
Submission date: 2020-03-28
Final revision date: 2020-04-29
Acceptance date: 2020-05-01
Publication date: 2020-05-22
Pol J Radiol, 2020; 85: 261-270
KEYWORDS
TOPICS
ABSTRACT
Purpose:
The incidental detection of one or more additional primary tumours during computed tomography (CT) staging of a patient with known malignancy is rare but possible. This occurrence should be considered by the radiologist when a new lesion is detected, especially if the lesion location is atypical for metastases. The purpose of this report was to document the usefulness of total body CT scan to detect synchronous primary malignancies in cancer patients undergoing a staging workup.
Material and methods:
This was done by reviewing the staging CT studies of the adult patients with a newly diagnosed cancer evaluated during a five-year period in a single cancer institute in order to identify any possible correlation, establishing which tumours are more frequently combined with a second tumour and which second tumours are more commonly present.
Results:
Among the patients with a second tumour, the most frequent first primary tumours were melanoma (eight patients, 17.8%), lymphoma (seven patients, 15.6%), and prostate carcinoma (seven patients, 15.6%). The most frequent incidentally detected second tumours were hepatocellular carcinoma (nine patients, 20% of 45 incidental tumours), renal carcinoma (eight patients, 17.8%), lung carcinoma (seven patients, 15.6%), and bladder carcinoma (four patients, 8.9%). One patient had three primary tumours synchronously.
Conclusions:
We believe that the radiologist’s knowledge of the prevalence and pattern of occurrence of these multiple primary malignancies represents added diagnostic value.
REFERENCES (34)
1.
Maurea S, Corvino A, Imbriaco M, et al. Simultaneous non-functioning neuroendocrine carcinoma of the pancreas and extra-.
2.
hepatic cholangiocarcinoma. A case of early diagnosis and favorable post-surgical outcome. JOP 2011; 12(3): 255-8.
3.
Corvino A, Corvino F, Radice L, et al. Synchronous mucinous colonic adenocarcinoma and multiple small intestinal adenocarcinomas: report of a case and review of literature. Clin Imaging 2015; 39(3): 538-42. doi: 10.1016/j.clinimag.2014.12.019. Epub 2015 Jan 7.
4.
Fritz A, Percy C, Jack A, editors. International Classification of Diseases for Oncology, third edition. Geneva, World Health Organization, 2000.
5.
Demandante CG, Troyer DA, Miles TP. Multiple primary malignant neoplasms: case report and a comprehensive review of the literature. Am J Clin Oncol 2003; 26(1): 79-83.
6.
Vogt A, Schmid S, Heinimann K, et al. Multiple primary tumours: challenges and approaches, a review. ESMO Open 2017; 2(2): e000172. doi: 10.1136/esmoopen-2017-000172. eCollection 2017.
7.
Coyte A, Morrison DS, McLoone P. Second primary cancer risk - the impact of applying different definitions of multiple primaries: results from a retrospective population-based cancer registry study. BMC Cancer 2014; 14: 272. doi: 10.1186/1471-2407-14-272.
8.
Tammaro V, Spiezia S, D’Angelo S, et al. Diagnostic Imaging Techniques for Synchronous Multiple Tumors. In: Renda A (ed.). Updates in Surgery. Multiple Primary Malignancies. Springer-Verlag 2009; p. 231-244.
9.
Dijkman BG, Schuurbiers OC, Vriens D, et al. The role of (18) F-FDG PET in the differentiation between lung metastases and synchronous second primary lung tumours. Eur J Nucl Med Mol Imaging 2010; 37(11): 2037-47. doi: 10.1007/s00259-010-1505-2. Epub 2010 Jun 10.
10.
Warren S, Gates O. Multiple primary malignant tumors: a survey of the literature and statistical study. Am J Cancer 1932; 16: 1358-414.
11.
Stephen BE, David RB, Carolyn CC, editors. AJCC Cancer Staging Manual. 7th ed. Springer, New York, USA 2010.
12.
Feinberg BA, Bharmal M, Klink AJ, et al. Using Response Evaluation Criteria in Solid Tumors in real-world evidence cancer research. Future Oncol 2018; 14(27): 2841-2848. doi: 10.2217/fon-2018-0317. Epub 2018 May 31.
13.
Renda A, Carlomagno N. Nosography. In: Renda A (ed.). Updates in Surgery. Multiple Primary Malignancies 2009; p. 231-244.
14.
Testori A, Cioffi U, De Simone M, et al. Multiple primary synchronous malignant tumors. BMC Res Notes 2015; 8: 730. doi: 10.1186/s13104-015-1724-5.
15.
Amer MH. Multiple neoplasms, single primaries, and patient survival. Cancer Manag Res 2014; 6: 119-34. doi: 10.2147/CMAR.S57378. eCollection 2014.
16.
Luciani A, Balducci L. Multiple primary malignancies. Semin Oncol 2004; 31(2): 264-73.
17.
Skelton WP 4th, Ali A, Skelton MN, et al. Analysis of Overall Survival in Patients With Multiple Primary Malignancies: A Single-center Experience. Cureus 2019; 11(4): e4552. doi: 10.7759/cureus.4552.
18.
Artac M, Bozcuk H, Ozdogan M, et al. Different clinical features of primary and secondary tumors in patients with multiple malignancies. Tumori 2005; 91(4): 317-20.
19.
Hayat MJ, Howlader N, Reichman ME, et al. Cancer statistics, trends, and multiple primary cancer analyses from the Surveillance, Epidemiology, and End Results (SEER) Program. Oncologist 2007; 12(1): 20-37.
20.
Lee JC, Teles MS. Prevalence of additional primary malignancies detected incidentally on PET/CT. Radiol Bras 2019; 52(5): 348. doi: 10.1590/0100-3984.2019.0097.
21.
Corvino A, Rosa D, Sbordone C, et al. Diastasis of rectus abdominis muscles: patterns of anatomical variation as demonstrated by ultrasound. Pol J Radiol 2019; 84: e542-e548. doi: 10.5114/pjr.2019.91303. eCollection 2019.
22.
Ros PR, Ji H. Special focus session: multisection (multidetector) CT: applications in the abdomen. Radiographics 2002; 22(3): 697-700.
23.
Kalra MK, Maher MM, D’Souza R, et al. Multidetector computed tomography technology: current status and emerging developments. J Comput Assist Tomogr 2004; 28 Suppl 1: S2-6.
24.
Tibana TK, Santos RFT, Arão Filho A, et al. Detection of additional primary malignancies: the role of CT and PET/CT combined with multiple percutaneous biopsy. Radiol Bras 2019; 52(3): 166-171. doi: 10.1590/0100-3984.2018.0024.
25.
Ueda T, Mori K, Minami M, et al. Trends in oncological CT imaging: clinical application of multidetector-row CT and 3D-CT imaging. Int J Clin Oncol 2006; 11(4): 268-77.
26.
Ertekin E, Amasyalı AS, Erol B, et al. Role of Contrast Enhancement and Corrected Attenuation Values of Renal Tumors in Predicting Renal Cell Carcinoma (RCC) Subtypes: Protocol for a Triphasic Multi-Slice Computed Tomography (CT) Procedure. Pol J Radiol 2017; 82: 384-391. doi: 10.12659/PJR.901957. eCollection 2017.
27.
Pfannenberg AC, Aschoff P, Brechtel K, et al. Value of contrast-enhanced multiphase CT in combined PET/CT protocols for oncological imaging. Br J Radiol 2007; 80(954): 437-45. Epub 2007 Feb 28.
28.
Thrall JH. Radiation exposure in CT scanning and risk: where are we? Radiology 2012; 264: 325-8. doi:
https://doi.org/10.1148/ radiol.12121137.
29.
Brenner DJ, Hall EJ. Computed tomography: an increasing source of radiation exposure. N Engl J Med 2007; 357: 2277-84. doi: https:// doi.org/10.1056/NEJMra072149.
30.
Phelps ME. Positron emission tomography provides molecular imaging of biological processes. Proc Natl Acad Sci U S A 2000; 97(16): 9226-33.
31.
Veit P, Kühle C, Beyer T, Kuehl H, et al. Whole body positron emission tomography/computed tomography (PET/CT) tumour staging with integrated PET/CT colonography: technical feasibility and first experiences in patients with colorectal cancer. Gut 2006; 55(1): 68-73.
32.
Townsend DW, Beyer T. A combined PET/CT scanner: the path to true image fusion. Br J Radiol 2002; 75 Spec No: S24-30.
33.
Antoch G, Freudenberg LS, Beyer T, et al. To enhance or not to enhance? 18F-FDG and CT contrast agents in dual-modality 18F-FDG PET/CT. J Nucl Med 2004; 45 Suppl 1: 56S-65S.
34.
Choi JY, Lee KS, Kwon OJ, et al. Improved detection of second primary cancer using integrated [18F] fluorodeoxyglucose positron emission tomography and computed tomography for initial tumor staging. J Clin Oncol 2005; 23(30): 7654-9.