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Block et al. Hepatoma Res 2019;5:21 Hepatoma Research
DOI: 10.20517/2394-5079.2019.17

Case report Open Access

Three primary malignancies in 17 years in a man
with chronic hepatitis B

Peter D. Block , Brianna J. Shinn , Christopher G. Roth , Jeffrey P. Baliff , Ralph G. Zinner , Hie-Won
2
4
3
1
1
Hann 5
1 Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
2 Department of Radiology, Abdominal Imaging Division, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
3 Department of Pathology, Anatomy, & Cell Biology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
4 Department of Medical Oncology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
5 Liver Disease prevention Center, Division of Gastroenterology and Hepatology Thomas Jefferson University Hospital,
Philadelphia, PA 19107, USA.
Correspondence to: Dr. Hie-Won Hann, FAASLD, Professor of Medicine, Liver Disease Prevention Center, Division of
Gastroenterology and Hepatology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
Email: hie-won.hann@jefferson.edu

How to cite this article: Block PD, Shinn BJ, Roth CG, Baliff JP, Zinner RG, Hann HW. Three primary malignancies in 17 years in a
man with chronic hepatitis B. Hepatoma Res 2019;5:21. http://dx.doi.org/10.20517/2394-5079.2019.17
Received: 6 Apr 2019 First Decision: 20 May 2019 Revised: 23 May 2019 Accepted: 28 May 2019 Published: 21 Jun 2019

Received: First Decision: Revised: Accepted: Published: Science Editor: Guang-Wen Cao Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Science Editor: Copy Editor: Production Editor:
Abstract
The occurrence of three primary malignancies in a single patient is an infrequent phenomonen with an estimated
occurrence at 0.1%. Notably, patients with hepatocellular carcinoma (HCC) are particularly unlikely to develop
extrahepatic primary malignancies. In this light, we present a case of patient with chronic hepatitis B who developed
HCC, as well as two other primary malignancies. This case exhibits an exceedingly rare combination of cancers,
underlining the importance of continued cancer surveillence in those with a history of primary malignancy.

Keywords: Hepatitis B virus, hepatocellular carcinoma, antiviral therapy, lung cancer, multiple malignancy

INTRODUCTION
Multiple primary malignancies (MPMs) is a phenomenon that has been described in the literature for
nearly a century . The frequency of MPMs has increased over time, which has been partly attributed to
[1]
improved surveillance and treatment options for cancer. Notably, a similar uptick in cases of second primary

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
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