Synchronous colorectal cancer and multiple myeloma with chest wall involvement: Is this a coincidence?

• Published in: Current problems in cancer 2017-11, Vol.41 (6), p.413-418
• Main Authors: Li, Qiu-Li, Ma, Jin-An, Li, Hai-Peng, Huang, Ren-Bing, Hu, Chun-Hong, Liu, Xian-Ling, Gao, Ya-Wen, Feng, Gang-Hua, Wu, Fang
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - blood; Adenocarcinoma - diagnosis; Adenocarcinoma - pathology; Adenocarcinoma - therapy; Anemia; Anemia, Refractory - blood; Anemia, Refractory - diagnosis; Anemia, Refractory - etiology; Anemia, Refractory - therapy; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Biopsy; Chemotherapy, Adjuvant - adverse effects; Colectomy; Colonoscopy; Colorectal cancer; Colorectal Neoplasms - blood; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - pathology; Colorectal Neoplasms - therapy; Early Detection of Cancer; Fluorouracil - adverse effects; Humans; Leucovorin - adverse effects; Male; Middle Aged; Multiple myeloma; Multiple Myeloma - blood; Multiple Myeloma - diagnosis; Multiple Myeloma - pathology; Multiple Myeloma - therapy; Multiple primary malignant neoplasms; Neoplasms, Multiple Primary - blood; Neoplasms, Multiple Primary - diagnosis; Neoplasms, Multiple Primary - pathology; Neoplasms, Multiple Primary - therapy; Organoplatinum Compounds - adverse effects; Prognosis; Syndrome; Thoracic Wall - pathology; Tomography, X-Ray Computed
• ISSN: 0147-0272; 1535-6345
• DOI: 10.1016/j.currproblcancer.2017.09.002

Multiple primary malignant neoplasms (MPMNs) are rare malignant neoplasms that simultaneously or successively occur in the same patient as 2 or more primary malignancies. Currently, an increasing number of cases are being reported. In general, MPMNs more commonly occur as 2 solid tumors or 2 hematological malignancies. Cases of MPMN that involve a solid tumor and a hematological malignancy are rare. Here, we report a case of synchronous colorectal cancer (CRC) and multiple myeloma (MM) with chest wall involvement. After reviewing the literature, we believe that there may be a distinct syndrome involving CRC and MM. The patient in our case study suffered refractory anemia following surgery and 2 cycles of chemotherapy. Initially, the anemia was considered to be a common manifestation of CRC in this patient. Interestingly, although he received a blood transfusion, his hemoglobin levels remained low. He later developed hematuria, proteinuria, multiple osteoporosis in the costal bones, and thrombocytopenia. These new symptoms drew our attention, and we considered a diagnosis of synchronous primary CRC and MM, with the anemia as a symptom of MM. Based on the results of a bone marrow aspirate, MM was confirmed. Therefore, when CRC is associated with refractory anemia, we should not only assume that anemia is a classical symptom of CRC, a result of chronic blood loss, nutritional deficiencies, or myelosuppression due to chemotherapy, but we should also consider that it may reflect the possibility of a coexisting hematologic malignancy. As the treatment of these 2 malignancies is different, early diagnosis and treatment based on definitive diagnosis as early as possible will be beneficial to overall prognosis.