Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2023; 15(11): 2627-2638
Published online Nov 27, 2023. doi: 10.4240/wjgs.v15.i11.2627
Metachronous primary esophageal squamous cell carcinoma and duodenal adenocarcinoma: A case report and review of literature
Chun-Chun Huang, Le-Qian Ying, Yan-Ping Chen, Min Ji, Lu Zhang, Lin Liu
Chun-Chun Huang, Le-Qian Ying, Yan-Ping Chen, Min Ji, Lu Zhang, Lin Liu, Department of Oncology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu Province, 210009, China
Co-first authors: Chun-Chun Huang and Le-Qian Ying.
Author contributions: Huang CC and Ying LQ equally contributed to manuscript writing and editing, and data collection; Ji M and Zhang L contributed to data analysis; Chen YP and Liu L contributed to conceptualization and supervision; and all authors have read and approved the final manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lin Liu, MD, Chief Physician, Department of Oncology, Zhongda Hospital, Medical School of Southeast University, Nanjing, Jiangsu Province, 210009, China 101012478@seu.edu.cn
Received: July 10, 2023
Peer-review started: July 10, 2023
First decision: September 6, 2023
Revised: September 23, 2023
Accepted: October 26, 2023
Article in press: October 26, 2023
Published online: November 27, 2023
Abstract
BACKGROUND

The prevalence of multiple primary malignant neoplasms (MPMNs) is increasing in parallel with the incidence of malignancies, the continual improvement of diagnostic models, and the extended life of patients with tumors, especially those of the digestive system. However, the co-existence of MPMNs and duodenal adenocarcinoma (DA) is rarely reported. In addition, there is a lack of comprehensive analysis of MPMNs regarding multi-omics and the tumor microenvironment (TME).

CASE SUMMARY

In this article, we report the case of a 56-year-old man who presented with a complaint of chest discomfort and abdominal distension. The patient was diagnosed with metachronous esophageal squamous cell carcinoma and DA in the Department of Oncology. He underwent radical resection and chemotherapy for the esophageal tumor, as well as chemotherapy combined with a programmed death-1 inhibitor for the duodenal tumor. The overall survival was 16.6 mo. Extensive evaluation of the multi-omics and microenvironment features of primary and metastatic tumors was conducted to: (1) Identify the reasons responsible for the poor prognosis and treatment resistance in this case; and (2) Offer novel diagnostic and therapeutic approaches for MPMNs. This case demonstrated that the development of a second malignancy may be independent of the location of the first tumor. Thus, tumor recurrence (including metastases) should be distinguished from the second primary for an accurate diagnosis of MPMNs.

CONCLUSION

Multi-omics characteristics and the TME may facilitate treatment selection, improve efficacy, and assist in the prediction of prognosis.

Keywords: Multiple primary malignancies, Esophageal tumor, Duodenal adenocarcinoma, Multi-omics, Tumor microenvironment, Case report

Core Tip: Multiple primary malignant neoplasms (MPMNs) are increasingly prevalent in clinical practice, most frequently in the digestive system. We report a rare case of MPMN with a combination of esophageal squamous cell carcinoma and duodenal adenocarcinoma. According to PubMed-indexed literature, there are no standard guidelines or expert consensus on the etiology and comprehensive treatment. We also conducted a detailed study of the features of primary and metastatic tumors. The aim of this report was to identify the reasons responsible for the poor prognosis and treatment resistance in this case through histological data and provide new diagnostic and treatment directions for MPMNs.