{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:06:17Z","timestamp":1792598777223,"version":"4.5.0"},"reference-count":21,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T00:00:00Z","timestamp":1622764800000},"content-version":"unspecified","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,5,12]]},"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:p>A 67-year-old woman underwent a medical check-up by her general practitioner after complaining of atypical pain in the shoulder girdle. Due to the important inflammatory syndrome noticed on blood testing, a polymyalgia rheumatica was suspected and she was started on corticosteroid treatment with good clinical response, but no impact on inflammation. She underwent extensive imaging with a thoraco-abdominal CT scanner that demonstrated a pancreatic mass, then later a PET-CT showed 3 different hyperactive lesions. Biopsies then revealed simultaneous diffuse large B-cell lymphoma (DLBCL), colorectal adenocarcinoma and pancreatic neuroendocrine tumour. She benefited from low rectal endoscopic excision of the colorectal tumour, R-CHOP chemotherapy for DLBCL and laparoscopic left pancreatectomy. Successful treatment required a good multidisciplinary collaboration between the different specialists. The patient made a good recovery and achieved complete remission at 1\u2009year. This an unusual presentation of multiple primary malignancies.<\/jats:p>","DOI":"10.1136\/bcr-2021-241938","type":"journal-article","created":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T11:12:01Z","timestamp":1622805121000},"page":"e241938","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Multiple primary malignancies: synchronous lymphoma, pancreatic neuroendocrine tumour and colorectal cancer"],"prefix":"10.1136","volume":"14","author":[{"given":"Nicolas","family":"Dayer","sequence":"first","affiliation":[{"name":"Internal Medicine, CHUV, Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Fasquelle","sequence":"additional","affiliation":[{"name":"Pathology, CHUV, Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela","family":"Salati","sequence":"additional","affiliation":[{"name":"Oncology, H\u00f4pital Riviera-Chablais, Rennaz, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles","family":"Dietrich","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, H\u00f4pital Riviera-Chablais, Rennaz, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,6,4]]},"reference":[{"key":"2025082709555571000_14.6.e241938.1","first-page":"1358","article-title":"Multiple primary malignant tumors: survey of the literature and a statistical study","volume":"16","author":"Warren","year":"1932","journal-title":"Am J Cancer"},{"key":"2025082709555571000_14.6.e241938.2","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1097\/00000658-196611000-00001","article-title":"Incidence of multiple primary cancers per man-year of follow up: 20-year review from the Ellis Fischel State Cancer Hospital","volume":"164","author":"Spratt","year":"1966","journal-title":"Ann Surg"},{"key":"2025082709555571000_14.6.e241938.3","article-title":"Multiple primary tumors over a lifetime","volume":"33","author":"Copur","year":"2019","journal-title":"Oncology"},{"key":"2025082709555571000_14.6.e241938.4","doi-asserted-by":"publisher","DOI":"10.1097\/00000421-200302000-00015"},{"key":"2025082709555571000_14.6.e241938.5","doi-asserted-by":"crossref","first-page":"17","DOI":"10.2217\/lmt-2017-0003","article-title":"Synchronous primary adenocarcinoma of the lung and pancreas: a case series and review of the literature","volume":"6","author":"Puri","year":"2017","journal-title":"Lung Cancer Manag"},{"key":"2025082709555571000_14.6.e241938.6","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1111\/j.1749-6632.1994.tb17255.x","article-title":"Expression of growth factors and their receptors in neuroendocrine gut and pancreatic tumors, and prognostic factors for survival","volume":"733","author":"\u00d6BERG","year":"1994","journal-title":"Ann N Y Acad Sci"},{"key":"2025082709555571000_14.6.e241938.7","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.11105"},{"key":"2025082709555571000_14.6.e241938.8","first-page":"308","article-title":"Aspects of the theoretical basis and clinical relevance of low acid states","volume":"89","author":"Modlin","year":"1994","journal-title":"Am J Gastroenterol"},{"key":"2025082709555571000_14.6.e241938.9","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1159\/000502384","article-title":"Metachronous and synchronous cancers in patients with neuroendocrine tumors","volume":"98","author":"Verrico","year":"2020","journal-title":"Oncology"},{"key":"2025082709555571000_14.6.e241938.10","doi-asserted-by":"publisher","DOI":"10.1097\/00004836-199303000-00009"},{"key":"2025082709555571000_14.6.e241938.11","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1159\/000381716","article-title":"Incidence of second primary malignancies in patients with neuroendocrine tumours","volume":"102","author":"Clift","year":"2015","journal-title":"Neuroendocrinology"},{"key":"2025082709555571000_14.6.e241938.12","first-page":"37","article-title":"Carcinoid tumors of the gastrointestinal tract","volume":"51","author":"Olney","year":"1985","journal-title":"Am Surg"},{"key":"2025082709555571000_14.6.e241938.13","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-11-0315"},{"key":"2025082709555571000_14.6.e241938.14","first-page":"215","article-title":"Multiple primary malignancies: a report of two cases","volume":"26","author":"Sakellakis","year":"2014","journal-title":"Chin J Cancer Res"},{"key":"2025082709555571000_14.6.e241938.15","doi-asserted-by":"publisher","DOI":"10.1097\/00000421-200008000-00011"},{"key":"2025082709555571000_14.6.e241938.16","doi-asserted-by":"crossref","first-page":"CMO.S7871","DOI":"10.4137\/CMO.S7871","article-title":"A study of aspects on gender and prognosis in synchronous colorectal cancer","volume":"5","author":"Derwinger","year":"2011","journal-title":"Clin Med Insights Oncol"},{"key":"2025082709555571000_14.6.e241938.17","first-page":"1","article-title":"Multiple primary malignant neoplasms. The Connecticut experience, 1935\u20131964","volume":"58","author":"Schoenberg","year":"1977","journal-title":"Recent Results Cancer Res"},{"key":"2025082709555571000_14.6.e241938.18","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/j.ijscr.2013.03.032","article-title":"An elderly woman with triple primary metachronous malignancy: a case report and review of literature","volume":"4","author":"Takalkar","year":"2013","journal-title":"Int J Surg Case Rep"},{"key":"2025082709555571000_14.6.e241938.19","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.41.8681"},{"key":"2025082709555571000_14.6.e241938.20","doi-asserted-by":"publisher","DOI":"10.1097\/00002281-200101000-00010"},{"key":"2025082709555571000_14.6.e241938.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2008.02.001"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-241938","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:56:09Z","timestamp":1756313769000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-241938"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6]]},"references-count":21,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6,4]]},"published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1136\/bcr-2021-241938"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-241938","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6]]}}}