Double primary malignancies could be divided into two categories, depending\non the interval between tumor diagnoses. A secondary malignancy could\nbe defined as a new cancer that has occurred as a result of previous treatment\nwith radiation or chemotherapy. Second primary malignancy can occur at\nany age but itâ??s commonly at old age. A 46 premenopausal female patient\npresented to our outpatient clinic complaining from a mass in her right\nbreast, routine metastatic work-up for distant metastasis declared multiple\nhepatic metastases, RT renal mass, and bone metastases. Palliative radiotherapy\nto tender and weight bearing sites followed by 4 cycles of systemic chemotherapy\nFEC regimen were received. Tru-cut needle biopsy from renal\nmass detected renal cell carcinoma of clear cell type, the patient started sunitinib\nand tamoxifen with bisphosphonate (Zoledronic acid), assessment of the\nresponse revealed reduction of the size and number of HFLs, and the size of\nrenal mass, so the patient was decided to do cytoreductive nephrectomy and\nthen continued on TAM and sunitinib. Collectively, due to the rising incidence\nof multiple primary malignancies, further studies should be done not\nonly for better clinical evaluation and treatments but also for accurate determination\nof possible causes, pathogenesis, effective managements and\nscreening programs.
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