PMC8416369_01
(a) Upper gastrointestinal endoscopy findings. A type 1 tumor with a diameter of 30 mm is found on the posterior wall of the gastric body. The tumor is easily bleeding. (b) Histopathologic findings of the biopsy specimens of gastric cancer. Findings of well-differentiated adenocarcinoma. Hematoxylin and eosin staining, x100. (c) Hematoxylin and eosin staining, x400.
CRIHEM2021-9965371.001.jpg
PMC8416369_01_CRIHEM2021-9965371.001.jpg
fig1
On upper gastrointestinal endoscopy, a type 1 tumor with a diameter of 30 mm was seen at the posterior wall of the corpus of the stomach, and the histopathological diagnosis of the tumor was tubular adenocarcinoma (Figures 1(a)-1(c)).
Clinical courses of the patient after gastric and lung cancers are diagnosed. The solid line indicates serum IgD level. Computed tomography (CT) shows the lung nodules and stomach. At the time of appearance, a pulmonary nodule with a diameter of 20 mm is found in the upper lobe of the left lung. The tumor grew over time, and a new intrapulmonary lesion appears after DOC treatment, but after nivolumab treatment, the new lesion almost disappeared and the primary lesion reduced. The gastric cancer could not be identified by CT at the start of treatment and had not changed since then. But 16 months after, gastric cancer increased. SOX: tegafur, gimeracil, oteracil potassium (TS-1), and oxaliplatin; DOC: docetaxel; Niv: nivolumab; Ld: lenalidomide and dexamethasone; DLd: daratumumab, lenalidomide, and dexamethasone, CEA: carcinoembryonic antigen.
CRIHEM2021-9965371.002.jpg
PMC8416369_01_CRIHEM2021-9965371.002.jpg
fig2
Furthermore, CT showed a pulmonary nodule with a diameter of 20 mm in the upper lobe of the left lung, and the diagnosis of the nodule was primary lung cancer clinical stage IA2 (T1bN0M0) based on the imaging findings (Figure 2). The patient died 17 months after the multiple primary cancers were diagnosed (Figure 2).