primary malignancies could be divided into two categories, depending on the
interval between tumor diagnoses. A secondary malignancy could be defined as a new cancer that has
occurred as a result of previous treatment with radiation or chemotherapy. Second primary malignancy
can occur at any age but it’s
commonly at old age. A 46 premenopausal female patient presented to our
outpatient clinic complaining from a mass in her right breast, routine
metastatic work-up for distant metastasis declared multiple hepatic metastases,
RT renal mass, and bone metastases. Palliative radiotherapy to tender and
weight bearing sites followed by 4 cycles of systemic chemotherapy FEC regimen
were received. Tru-cut needle biopsy from renal mass detected renal cell carcinoma
of clear cell type, the patient started sunitinib and tamoxifen with
bisphosphonate (Zoledronic acid), assessment of the response revealed reduction
of the size and number of HFLs, and the size of renal mass, so the patient was
decided to do cytoreductive nephrectomy and then continued on TAM and
sunitinib. Collectively, due to
the rising incidence of multiple primary malignancies, further studies should
be done not only for better clinical evaluation and treatments but also for
accurate determination of possible causes, pathogenesis, effective managements
and screening programs.
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