田坤,作者= Ma Xue-Yan太阳Peng-Fei TITLE =多原发性恶性肿瘤:病例报告和综合文献综述肿瘤体积= =前沿》杂志上12年= 2023 URL = //www.thespel.com/articles/10.3389/fonc.2022.10雷竞技rebat90634 DOI = 10.3389 / fonc.2022.1090634 ISSN = 2234 - 943 x文摘=多原发性肿瘤,特别是四原发性肿瘤,临床上极为罕见,没有标准的临床管理的协议。我们描述一个案件中,骨肿瘤,恶性膀胱肿瘤,恶性黑色素瘤,肝内胆管癌都是原始的恶性肿瘤。患者是一位79岁的女性接受了左中指骨肿瘤手术45年前,以及膀胱恶性肿瘤手术和术后辅助化疗15年前,和精确的病理结果和治疗尚不清楚。一年前,她接受了截肢的脚趾由于黑色的质量对脚趾和病理检查确诊为有雀斑的极端的恶性黑色素瘤。术后辅助药物治疗之前,PET / CT显示恶性肿瘤外侧段肝左叶,和多个各项检验在左腮腺,门的肝脏、腹膜后。肝内胆管癌被发现在肝脏穿刺活检的病理报告。血清样本的下一代测序(上天)显示一个错义突变,指定的P。G12V, KRAS基因外显子2的。基于恶性黑色素瘤患者和肝内胆管癌,她收到了6周期的GP(吉西他滨/顺铂)结合Camrelizumab系统性疗法,和紧随其后的是3 Camrelizumab维护周期疗法,疗效评估是稳定的疾病(SD)治疗期间。当第四周期Camrelizumab建议维持治疗,疗效评价显示,肿瘤已经非常先进。病人拒绝继续抗肿瘤治疗和感染性休克和多器官功能衰竭去世以后3个月。 The patient had satisfactory efficacy and lived for a year after being diagnosed with two primary cancers. Despite the rarity of quadruple primary tumors and the lack of a conventional clinical management strategy, we postulate that germline mutations in the KRAS gene may be closely associated with the formation and development of multiple primary tumors. NGS testing is necessary for clinical management, and systemic treatment based on concurrent multiple main tumors is the key to improving prognosis.