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Many of the syndromes predispose to multiple
forms of cancer, suggesting that some of the pathways may be shared by
different tumors. This is a concept that has been proposed also by
Vogelstein and Kinsella. For example, our long-term follow up of patients
with retinoblastoma led by Ruth Kleinerman has revealed a striking
predisposition to second cancers among the hereditary cases, with about
one-half developing sarcomas both outside in the bottom line and especially
inside in the upper line in the radiation fields, as well as melanoma and
other tumors. In a study that appeared in the most recent issue of JNCI, we
reported that a high percent of the soft tissue tumors are leiomyosarcomas,
with many arising at older ages and outside the radiation field. |