It is necessary to conduct regular examinations in patients with malignancy or cancer because secondary cancers can arise either from primary cancer or other types of cancer from other tissues.
Multiple primary malignancies or cancer have increased over the past decade and people’s changing lifestyles. Malignancy and cancer are caused by the uncontrolled growth of body cells and occur in almost every type of cell in the human body which eventually causes various types of cancer. Cancer leads to tissue damage and spread throughout the body, and eventually causes death. Malignancies or primary tumor is called “primary tumor” and the spread or metastasis of cancer is called “secondary tumor”. Cancer patient possibly has more than one primary tumor from the different tissue or multimalignancy. In general, cancer has significantly burdened the body. Two types of cancer at one time will increase the body’s burden of disease and increase the risk of mortality, morbidity, and quality of life for patients. The management of patients with multiple malignancies also requires special expertise and is a challenge for clinicians.
As the prevalence of cancer in general increases, the prevalence of multiple malignancies also increases. Male and elderly patients mostly undergo this situation. The incidence of multi-malignancy is relatively common in patients with breast cancer (15.6%) and lung cancer (22.9%). It is rare to find multiple malignancies in non-Hodgkin’s lymphoma. Until now, there are no specific management guidelines for this case.
The patient came with a painless lump under her left eye in January 2019. In early 2018, she had a lump in her right breast which was then surgically removed in June 2018. The patient never had chemotherapy before. The infraorbital lump occurred 6 months following the breast lump.
Histopathology examination of the lump on the right breast revealed that the patient was diagnosed with right infiltrating ductal carcinoma (luminal A) BC grade III stage IIA. A histopathological examination of the left eye showed Non-Hodgkin Lymphoma, B cell type, stage IAE.
The Medical Team further discussed the most appropriate treatment for the patient’s condition according to scientific proof. The patient was given R-CHOP chemotherapy, followed by hormonal therapy after 6-cycles of chemotherapy. The inhibiting factors that occur are related to the COVID-19 pandemic and PPKM for delayed patient follow-up and follow-up monitoring. However, the patient managed to respond well to the treatment for the lump on the left eye and right breast, performing and functioning well. Acute and chronic complications related to chemotherapy are not documented.
Patient with non-Hodgkin lymphoma and breast cancer underwent a therapeutic approach through CHOP chemotherapy and breast cancer hormonal treatment. It is necessary to conduct regular examinations in patients with malignancy or cancer because secondary cancers can arise either from primary cancer or other types of cancer from other tissues.
Author: Prof. Dr. Ami Ashariati Prayoga, dr., Sp.PD-KHOM.
The case report can be accessed on Annals of Medicine and Surgery (Elsevier) at: https://www.sciencedirect.com/science/article/pii/S2049080122010603#bib2.
