Occurrence of Multiple Neoplasms in Patient with Chronic Myeloid Leukemia: Case Report

Abstract

Introduction: Chronic myeloid leukemia is a clonal myelo-proliferative disorder with a specific cytogenetic abnormality, a product of the translocation between chromosomes 9 and 22, with subsequent production of a protein with altered tyrosine kinase activity. Historical treatments with drugs such as busulfan, hydroxyurea and interferon are now little used because of the emergence of tyrosine kinase inhibitors, whose main representative drug is Imatinib Mesylate. This is a first-line therapy, and it is well tolerated by patients with low risk of severe adverse events. However, in approximately 10 years of use, there is still some concern about the long-term side effects, such as the development of a second malignancy. Objective: To describe the occurrence of multiple neoplasms in a patient with chronic myeloid leukemia. Method: We report a patient with chronic myeloid leukemia for 13 years, who had used hydroxyurea and interferon as prior therapies and has been using imatinib mesylate for 9 years. Results: Two years ago, the patient developed 2 nodules in his left thigh, which were completely resected. Myxoid lipo sarcoma was diagnosed and he underwent radiotherapy. The computed tomography of the abdomen of control at 6 months detected speculated nodule in the mesenchymal fat adjacent to the jejunum/ileum. After exploratory laparotomy and resection were performed, the pathology showed desmoids fibromatosis. Conclusion: A person with a malignant tumor has an increased risk of developing a second cancer, which may occur in patients with chronic myeloid leukemia. This association may be related to the drugs used in its treatment.