Concomitant Gastric Malignancy and Hepatocellular Carcinoma.

Area of Science:

• Gastroenterology
• Oncology
• Pathology

Background:

• Multiple primary malignant tumors (MPMTs) involve two or more distinct cancers diagnosed concurrently.
• Digestive system tumors are the most frequently associated malignancies in MPMTs.
• Advances in cancer therapy are increasing patient survival, potentially leading to MPMTs.

Observation:

• A male patient in his 60s presented with melena and a persistent gastric ulcer.
• Biopsies revealed Epstein-Barr virus (EBV)-positive lymphoepithelioma-like gastric carcinoma (LELGC).
• Incidental liver lesion biopsy confirmed hepatocellular carcinoma (HCC) unrelated to the gastric tumor, associated with hepatitis C virus (HCV).

Findings:

• This case presents a rare occurrence of MPMTs involving a rare gastric malignancy (LELGC) and HCC.
• The patient had non-cirrhotic HCC, a known but uncommon complication of HCV.
• The two malignancies showed no morphologic similarity.

Implications:

• Clinicians must maintain a high index of suspicion for MPMTs due to increasing cancer survival rates.
• The presence of MPMTs significantly impacts treatment strategies and patient prognosis.
• This case underscores the importance of thorough evaluation for concurrent malignancies.