Abstract

TAILORED APPROACH FOR MULTIPLE PRIMARY NEOPLASMS

Author(s): Shailley Arora Sehgal, Parul Gupta, Anil Kumar Dhull, Vivek Kaushal

BACKGROUND Due to rarity and inadequate reporting, Multiple Primary Malignant Tumours (MPMTs) still create a perplexing situation in our clinics. However, they are on an increasing trend as result of better investigative work up and treatment modalities leading to prolonged survival. Database maintenance is must to report them. We are hereby reporting a case series to add to the limited literature available and help define investigational and treatment strategy. MATERIALS AND METHODS Database of our institute from year 2012 to 2018 was searched for patients with MPMTs and they were categorized in metachronous and synchronous malignant tumours. We also studied the various parameters simultaneously, pertaining to their clinical presentation, work up, performance status, management and outcome. RESULTS 17 were found to have multiple malignancies out of 15,922 patients. In them 7-patients had synchronous primary malignancies and 10-patients have single primary malignancy at presentation and developed subsequent second malignancies over a period of 4-months to 11-years. Maximum number of first malignancies was of the head and neck region followed by breast. CONCLUSION Getting a MPMT diagnosed is a challenge for both patient and treating clinician. Prognosis should not be considered poor in such patients per se but early and meticulous work up and diagnosis is prerequisite for radical treatment. This case series will help in providing insight into the management of such patients, however a tailored approach based on the experience of clinician, patients’ performance status and available resources is must.