Case Study

1. Case Series of Dual Malignancies

A 64-year-old woman was diagnosed with left breast cancer. Staging with PET-CECT revealed an incidental right renal mass, suggestive of renal cell carcinoma (RCC).
She underwent modified radical mastectomy (MRM) for breast cancer and radical nephrectomy for RCC.
Histopathology (HPR) confirmed pT2N0 breast cancer and clear cell RCC.
Due to a high Ki-67 index, she received adjuvant chemotherapy and is now on hormonal therapy for breast cancer management.

A 62-year-old woman presented with Stage IIb cervical cancer.
PET-CECT done for staging incidentally detected a thyroid nodule and colonic polyps.
Fine-needle aspiration of the thyroid confirmed Papillary Thyroid Carcinoma (PTC), while colonoscopy showed polyps with high-grade dysplasia.
She underwent colonoscopic removal of the polyps, followed by definitive chemoradiotherapy for cervical cancer.
Post-radiation, she had a total thyroidectomy, which revealed classic PTC without any high-risk pathological features.
Six-month follow-up PET-CT and colonoscopy showed no signs of disease recurrence or remaining dysplastic polyps.
Genetic evaluation uncovered a germline RAD51D mutation, suggesting a genetic susceptibility to multiple cancers.

A 66-year-old man presented with oligometastatic rectal cancer with lung nodules and locally advanced prostate cancer.
He received total neoadjuvant therapy (TNT) for rectal cancer and radical radiotherapy with hormonal therapy for prostate cancer.
Response scans and tumor markers showed remarkable response at the primary sites and complete resolution of lung nodules.
He underwent a laparoscopic low anterior resection (challenging due to post-radiation fibrosis) and bilateral scrotal orchidectomy.
HPR findings: Residual moderately differentiated adenocarcinoma with negative margins and complete total mesorectal excision.

A 65-year-old man with hypertension and diabetes, previously treated for squamous cell carcinoma of the upper esophagus with definitive chemoradiation, presented with a left lower lobe lung mass.
PET-CECT confirmed a non-metastatic lung tumor, and biopsy revealed adenosquamous carcinoma.
After discussion in a tumor board, it was classified as a second primary malignancy, and he underwent Uniportal VATS Left Lower Lobectomy.
Postoperatively, he demonstrated excellent recovery with:
- Pain-free ambulation and good spirometry effort within 24 hours.
- Full lung expansion on X-ray.
- Chest drain removal by post-op day 4 and discharge readiness.
Lung resections require exceptional precision, and Uniportal Video-Assisted Thoracoscopic Surgery (VATS) further enhances patient recovery compared to multiportal VATS or open thoracotomy.
Uniportal VATS has significantly improved patient outcomes and recovery times.
This is likely one of the first such procedures in our region.

A 59-year-old man, with no significant comorbidities, was diagnosed with locally advanced gastric cancer.
He received four cycles of FLOT regimen (perioperative chemotherapy) before surgery.
He underwent Total Gastrectomy with D2 Lymphadenectomy and reconstruction using a Jejunal Pouch with Roux-en-Y Esophagojejunostomy.
HPR confirmed an R0 resection (negative margins).
He successfully completed adjuvant chemotherapy.

Reduced Post-Gastrectomy Symptoms: Helps minimize early dumping syndrome, reflux, and postprandial discomfort.
Enhanced Quality of Life: The patient reported better meal tolerance, reduced postprandial bloating, and improved weight maintenance compared to traditional Roux-en-Y alone.

Cancer Surgeon

Appointment