Acute myeloid leukemia with gastric carcinoma - A case report of a double malignancy

Sep 21, 2026

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Multiple primary cancers (MPC) describe malignant tumors presenting as more than one primary malignancy in the same patient, either simultaneously or sequentially. This case report details an untreated 58-year-old male with acute myeloid leukemia and cardia adenocarcinoma, initially presenting with severe chest pain and mild pallor. Molecular findings indicated high-risk AML, treated with azacitidine plus venetoclax, followed by allogeneic stem cell transplantation. Complete relief with 99.63% complete chimerism was achieved, enabling radical gastric cancer surgery.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages5

Reading Time13 min

AccessFree to download

Abstract

Rationale

Patient concerns

Diagnosis

Interventions

Outcomes

Lessons

Introduction

Multiple primary cancers (MPC)

Case presentation

Funding and ethics

® Clinical Case Report Acute myeloid leukemia with gastric carcinoma A case report of a double malignancy Qiuxia Wan, MDa , Yongzhen Chen, MDb , Suyun Wang, MD, PhDa ,* | Abstract
Rationale: Multiple primary cancers (MPC) are malignant tumors that manifest as multiple primary tumors diagnosed in the same patient, either simultaneously or sequentially. Billroth first proposed the concept in 1889. Here, we report a rare case of untreated acute myeloid leukemia (AML) and adenocarcinoma of the cardia.
Patient concerns: A 58-year-old male with muscle and joint pain for >1 month was admitted to the hospital with severe chest pain for 3 hours on July 14, 2023. The patient had chest tightness, shortness of breath, and dyspnea. The skin, mucosa, and lips of the patient were slightly pale and the sternum had mild tenderness. Other systemic examinations did not reveal any obvious abnormalities. The results of routine blood tests on admission were as follows: white blood cells, 7.46 × 109/L; red blood cells, 2.32 × 1012/L; hemoglobin, 90 g/L; and platelets, 62 × 109/L.
Diagnosis: The patient was diagnosed with acute myeloid leukemia (FLT3, DNMT3A, U2AF1, and SMC3 mutations; KMT2A amplification; high-risk) and adenocarcinoma of the cardia.
Interventions: The patient was treated with azacitidine + Veneckla chemotherapy, and through precise regulation, the patient survived the period of bone marrow suppression. He was unable to achieve complete relief and finally underwent allogeneichematopoietic stem cell transplantation in February 2024.
Outcomes: Bone marrow cytology and minimal residual disease analysis indicated complete relief on April 22, 2024, with the bone marrow exhibiting complete chimerism (99 .63%) . The patient and his family members decided to seize the opportunity to perform radical surgical treatment for gastric cancer on May 16, 2024.
Lessons: The development of medicine, especially in oncology, has led to an increased possibility of developing multiple cancers. Clinically, some doctors may not be aware of the existence of multiple primary cancers, especially simultaneous carcinomas, which can be easily missed or misdiagnosed.
Abbreviations: AML = acute myeloid leukemia, CT = computed tomography, CTA = computed tomography angiography, MPC = multiple primary cancer. | | --- | | Keywords: acute myeloid leukemia, adenocarcinoma of the cardia, gastric carcinoma, multiple primary cancer | 1. Introduction Multiple primary cancers (MPC) are malignant tumors that manifest as more than 1 primary tumor in the same patient, either simultaneously or sequentially.[1] The development of medicine, especially in oncology, has helped prolong cancer patient survival but has also led to an increased possibility of developing multiple cancers. There have been many reports in the literature on MPCs involving solid organs; however, a double malignancy involving the hematopoietic system and a solid This study was supported by the Foundation of the Longhua District Health System Project Cooperation 2023 (Effect analysis ofitripopar converted to avatripopar in the treatment of ITP), Shenzhen Science and Technology Program (No.JCYJ20230807151307015) and Shenzhen Longhua District Foundation of Science and Technology (No. 11501A20220923BF690D7). Informed written consent was obtained from the patient for publication of this case report and accompanying images. The authors have no conflicts of interest to disclose. All data generated or analyzed during this study are included in this published article [and its supplementary information files]. All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. a Department of Hematology, Shenzhen Longhua District Central Hospital, Shenzhen, Guangdong China, b Depart

FAQs

What does MPC mean in this case report?

Multiple primary cancers (MPC) are malignant tumors showing more than one primary tumor in the same patient, diagnosed simultaneously or sequentially.

How was the patient diagnosed?

The patient was diagnosed with acute myeloid leukemia (FLT3, DNMT3A, U2AF1, SMC3 mutations; KMT2A amplification; high-risk) and adenocarcinoma of the cardia.

What treatments led to the reported outcome?

He received azacitidine plus venetoclax, then allogeneic hematopoietic stem cell transplantation in February 2024, followed by radical surgical treatment for gastric cancer in May 2024 after complete relief was confirmed.

Sep 21, 2026

Upload by Oliver