Evidence map›Paper›PMID 40603091›Full record

ArticleInternal medicine (Tokyo, Japan)2026

Four Metachronous Cancers: Mutation Profiling Can Be Used to Distinguish Multiple Primary Cancers from Metastases.

Etsuko Hisanaga, Takaaki Sano, Hideaki Yokoo

Abstract readCase Reports
In one paragraph

Article in Internal medicine (Tokyo, Japan), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Etsuko HisanagaClinical Department of Pathology, Gunma University Hospital, Japan.
Takaaki SanoDepartment of Diagnostic Pathology, Graduate School of Gunma University, Japan.
Hideaki YokooClinical Department of Pathology, Gunma University Hospital, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Distinguishing between primary and metastatic tumors is critical in patients with multiple cancers. We present the case of a man in his 70s with quadruple carcinoma, squamous cell carcinoma in both lungs, invasive urothelial carcinoma of the bladder, and esophageal cancer, discovered during follow-up after sigmoid colon cancer surgery. A histopathological analysis, including immunostaining, could not confirm whether these were primary or metastatic cancer. A comprehensive oncogene mutation analysis using next-generation sequencing revealed distinct gene mutations in each tumor, confirming that all were primary cancers of heterogeneous origin. Our findings highlight the importance of advanced genomic studies on complex cancer cases.

Indexed as

Carcinoma, Squamous CellEsophageal NeoplasmsLung NeoplasmsMutationNeoplasms, Multiple PrimaryNeoplasms, Second PrimaryUrinary Bladder NeoplasmsAgedDiagnosis, DifferentialDNA Mutational AnalysisHumansMalemetachronous cancersmutation profilingsquamous cell carcinoma

Identifiers

PMID40603091
PMCPMC12854961

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.