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Open Access Case Report

Radiation induced esophageal adenocarcinoma in a woman previously treated for breast cancer and renal cell carcinoma

Soundouss Raissouni1*, Ferdaous Raissouni2, Ghizlane Rais1, Meryem Aitelhaj1, Siham Lkhoyaali1, Rachida Latib3, Amina Mohtaram1, Fadoua Rais4, Hind Mrabti1, Nawal Kabbaj2, Naima Amrani2 and Hassan Errihani1

Author Affiliations

1 Medical Oncology Department, National Institute of Oncology, Rabat, Morocco

2 EFD- hepato-gastro-enterology, Ibn Sina University Hospital, Rabat, Morocco

3 Radiology department, National Institute of Oncology, Rabat, Morocco

4 xRadiotherapy department National Institute of Oncology, Rabat, Morocco

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BMC Research Notes 2012, 5:426  doi:10.1186/1756-0500-5-426

Published: 9 August 2012

Abstract

Background

Secondary radiation-induced cancers are rare but well-documented as long-term side effects of radiation in large populations of breast cancer survivors. Multiple neoplasms are rare. We report a case of esophageal adenocarcinoma in a patient treated previously for breast cancer and clear cell carcinoma of the kidney.

Case presentation

A 56 year-old non smoking woman, with no alcohol intake and no familial history of cancer; followed in the National Institute of Oncology of Rabat Morocco since 1999 for breast carcinoma, presented on consultation on January 2011 with dysphagia. Breast cancer was treated with modified radical mastectomy, 6 courses of chemotherapy based on CMF regimen and radiotherapy to breast, inner mammary chain and to pelvis as castration. Less than a year later, a renal right mass was discovered incidentally. Enlarged nephrectomy realized and showed renal cell carcinoma. A local and metastatic breast cancer recurrence occurred in 2007. Patient had 2 lines of chemotherapy and 2 lines of hormonotherapy with Letrozole and Tamoxifen assuring a stable disease. On January 2011, the patient presented dysphagia. Oesogastric endoscopy showed middle esophagus stenosing mass. Biopsy revealed adenocarcinoma. No evidence of metastasis was noticed on computed tomography and breast disease was controlled. Palliative brachytherapy to esophagus was delivered. Patient presented dysphagia due to progressive disease 4 months later. Jejunostomy was proposed but the patient refused any treatment. She died on July 2011.

Conclusion

We present here a multiple neoplasm in a patient with no known family history of cancers. Esophageal carcinoma is most likely induced by radiation. However the presence of a third malignancy suggests the presence of genetic disorders.

Keywords:
Esophageal cancer; Radiation induced; Breast cancer; Renal cell carcinoma; Multiple neoplasm