Multiple Primary Metachronous Malignancies, Namely Kidney, Colon, Uterus, and Breast Cancer: A Case Report
-
Arian Karimi Rouzbahani
,
Yahya Baharvand Irannia
,
Shahram Ahmadi Somaghian
,
Golnaz Mahmoudvand
,
Omid-Ali Adeli
,
Reza Yusofvand
Abstract
The incidence of multiple primary malignancies (MPMs) has risen in clinical practice; however, cases involving three or more primary cancers remain rare. A 56-year-old postmenopausal female with a significant familial cancer history developed four primary malignancies: papillary renal cell carcinoma, endometrial stromal sarcoma, colon adenocarcinoma, and invasive ductal carcinoma of the breast. The patient passed away after one year of receiving palliative treatment for her metastatic breast cancer. This study reviews 33 cases of MPMs, primarily involving breast, colon, and uterine cancers, mostly in women over 60. Genetic predisposition plays a significant role, with 35.5% having hereditary cancer syndromes. This report emphasizes the importance of considering new masses in cancer patients as potential new malignancies. Early detection using
fluorodeoxyglucose positron emission tomography (FDG-PET), implementing genetic testing, and timely cancer screenings in high-risk families significantly improve patient outcomes and management.
[1] Sohrabi C, Mathew G, Maria N, Kerwan A, Franchi T, Agha RA. The SCARE 2023 guideline: updating consensus Surgical CAse REport (SCARE) guidelines. Int J Surg. 2023;109(5):1136-1140. https://doi.org/10.1097/JS9.0000000000000373
[2] Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2021. CA Cancer J Clin. 2021;71(1):7-33. https://doi.org/10.3322/caac.21654
[3] Vogt A, Schmid S, Heinimann K, Frick H, Herrmann C, Cerny T, et al. Multiple primary tumours: challenges and approaches, a review. ESMO Open. 2017;2(2):e000172. https://doi. org/10.1136/esmoopen-2017-000172
[4] Noh SK, Yoon JY, Ryoo UN, Choi CH, Sung CO, Kim TJ, et al. A case report of quadruple cancer in a single patient including the breast, rectum, ovary, and endometrium. J Gynecol Oncol. 2008;19(4):265-269. https://doi.org/10.3802/jgo.2008.19.4.265
[5] Zhai C, Cai Y, Lou F, Liu Z, Xie J, Zhou X, et al. Multiple primary malignant tumors: a clinical analysis of 15,321 patients with malignancies at a single center in China. J Cancer. 2018;9(16):2795. https://doi.org/10.7150/jca.25482
[6] Kato T, Suzuki K, Muto Y, Sasaki J, Tsujinaka S, Kawamura YJ, et al. Multiple primary malignancies involving primary sporadic colorectal cancer in Japan: incidence of gastric cancer with colorectal cancer patients may be higher than previously recognized. World J Surg Oncol. 2015;13:1-7. https://doi. org/10.1186/s12957-014-0432-2
[7] Beisland C, Talleraas O, Bakke A, Norstein J. Multiple primary malignancies in patients with renal cell carcinoma: a national population-based cohort study. BJU Int. 2006;97(4):698-702. https://doi.org/10.1111/j.1464-410X.2006.06004.x
[8] Bittorf B, Kessler H, Merkel S, Brückl W, Wein A, Ballhausen W, et al. Multiple primary malignancies: an epidemiological and pedigree analysis of 57 patients with at least three tumours. Eur J Surg Oncol. 2001;27(3):302-313. https://doi.org/10.1053/ejso.2001.1112
[9] Suzuki T, Takahashi H, Yao K, Inagi K, Nakayama M, Makoshi T, et al. Multiple primary malignancies in the head and neck: a clinical review of 121 patients. Acta Otolaryngol. 2002;122(4):88-92. https://doi.org/10.1080/000164802760057662
[10] Xu L, Gu K. Clinical retrospective analysis of cases with multiple primary malignant neoplasms. Genet MolRes. 2014;13(4):9271- 9284. https://doi.org/10.4238/2014.March.12.19
[11] Nyqvist J, Kovács A, Einbeigi Z, Karlsson P, Forssell-Aronsson E, Helou K, et al. Genetic alterations associated with multiple primary malignancies. Cancer Med. 2021;10(13):4465-4477. https://doi.org/10.1002/cam4.3975
[12] Bychkovsky BL, Lo MT, Yussuf A, Horton C, Richardson M, LaDuca H, et al. Prevalence and spectrum of pathogenic
variants among patients with multiple primary cancers evaluated by clinical characteristics. Cancer. 2022;128(6):1275-
1283. https://doi.org/10.1002/cncr.34056
[13] Prime S, Thakker N, Pring M, Guest P, Paterson I. A review of inherited cancer syndromes and their relevance to oral
squamous cell carcinoma. Oral Oncol. 2001;37(1):1-16. https://doi.org/10.1016/S1368-8375(00)00055-5
[14] Lee E, Ji YI. A case of uterine carcinosarcoma detected simultaneously with breast and colon cancer (triple primary
malignant tumor). Case Rep Oncol. 2018;11(2):431-435. https://doi.org/10.1159/000489844
[15] Li G, Yao J, Wu T, Chen Y, Wang Z, Wang Y, et al. Triple metachronous primary cancer of uterus, colon, and breast
cancer: a case report and review of the literature. Medicine (Baltimore). 2020;99(34):e21764. https://doi.org/10.1097/
MD.0000000000021764
[16] Phupong V, Khemapech N, Triratanachat S. Triple synchronous primary cervical, endometrial and ovarian cancer with four different histologic patterns. Arch Gynecol Obstet. 2007;276:655-658. https://doi.org/10.1007/s00404-007- 0392-7
[17] Yasuda S, Ide M, Fujii H, Nakahara T, Mochizuki Y, Takahashi W, et al. Application of positron emission tomography imaging to cancer screening. Br J Cancer. 2000;83(12):1607-1611. https://doi.org/10.1054/bjoc.2000.1496
[2] Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2021. CA Cancer J Clin. 2021;71(1):7-33. https://doi.org/10.3322/caac.21654
[3] Vogt A, Schmid S, Heinimann K, Frick H, Herrmann C, Cerny T, et al. Multiple primary tumours: challenges and approaches, a review. ESMO Open. 2017;2(2):e000172. https://doi. org/10.1136/esmoopen-2017-000172
[4] Noh SK, Yoon JY, Ryoo UN, Choi CH, Sung CO, Kim TJ, et al. A case report of quadruple cancer in a single patient including the breast, rectum, ovary, and endometrium. J Gynecol Oncol. 2008;19(4):265-269. https://doi.org/10.3802/jgo.2008.19.4.265
[5] Zhai C, Cai Y, Lou F, Liu Z, Xie J, Zhou X, et al. Multiple primary malignant tumors: a clinical analysis of 15,321 patients with malignancies at a single center in China. J Cancer. 2018;9(16):2795. https://doi.org/10.7150/jca.25482
[6] Kato T, Suzuki K, Muto Y, Sasaki J, Tsujinaka S, Kawamura YJ, et al. Multiple primary malignancies involving primary sporadic colorectal cancer in Japan: incidence of gastric cancer with colorectal cancer patients may be higher than previously recognized. World J Surg Oncol. 2015;13:1-7. https://doi. org/10.1186/s12957-014-0432-2
[7] Beisland C, Talleraas O, Bakke A, Norstein J. Multiple primary malignancies in patients with renal cell carcinoma: a national population-based cohort study. BJU Int. 2006;97(4):698-702. https://doi.org/10.1111/j.1464-410X.2006.06004.x
[8] Bittorf B, Kessler H, Merkel S, Brückl W, Wein A, Ballhausen W, et al. Multiple primary malignancies: an epidemiological and pedigree analysis of 57 patients with at least three tumours. Eur J Surg Oncol. 2001;27(3):302-313. https://doi.org/10.1053/ejso.2001.1112
[9] Suzuki T, Takahashi H, Yao K, Inagi K, Nakayama M, Makoshi T, et al. Multiple primary malignancies in the head and neck: a clinical review of 121 patients. Acta Otolaryngol. 2002;122(4):88-92. https://doi.org/10.1080/000164802760057662
[10] Xu L, Gu K. Clinical retrospective analysis of cases with multiple primary malignant neoplasms. Genet MolRes. 2014;13(4):9271- 9284. https://doi.org/10.4238/2014.March.12.19
[11] Nyqvist J, Kovács A, Einbeigi Z, Karlsson P, Forssell-Aronsson E, Helou K, et al. Genetic alterations associated with multiple primary malignancies. Cancer Med. 2021;10(13):4465-4477. https://doi.org/10.1002/cam4.3975
[12] Bychkovsky BL, Lo MT, Yussuf A, Horton C, Richardson M, LaDuca H, et al. Prevalence and spectrum of pathogenic
variants among patients with multiple primary cancers evaluated by clinical characteristics. Cancer. 2022;128(6):1275-
1283. https://doi.org/10.1002/cncr.34056
[13] Prime S, Thakker N, Pring M, Guest P, Paterson I. A review of inherited cancer syndromes and their relevance to oral
squamous cell carcinoma. Oral Oncol. 2001;37(1):1-16. https://doi.org/10.1016/S1368-8375(00)00055-5
[14] Lee E, Ji YI. A case of uterine carcinosarcoma detected simultaneously with breast and colon cancer (triple primary
malignant tumor). Case Rep Oncol. 2018;11(2):431-435. https://doi.org/10.1159/000489844
[15] Li G, Yao J, Wu T, Chen Y, Wang Z, Wang Y, et al. Triple metachronous primary cancer of uterus, colon, and breast
cancer: a case report and review of the literature. Medicine (Baltimore). 2020;99(34):e21764. https://doi.org/10.1097/
MD.0000000000021764
[16] Phupong V, Khemapech N, Triratanachat S. Triple synchronous primary cervical, endometrial and ovarian cancer with four different histologic patterns. Arch Gynecol Obstet. 2007;276:655-658. https://doi.org/10.1007/s00404-007- 0392-7
[17] Yasuda S, Ide M, Fujii H, Nakahara T, Mochizuki Y, Takahashi W, et al. Application of positron emission tomography imaging to cancer screening. Br J Cancer. 2000;83(12):1607-1611. https://doi.org/10.1054/bjoc.2000.1496
| Files | ||
| Issue | Vol 10 No 5 (2025): September - October | |
| Section | Case Report(s) | |
| Keywords | ||
| Breast neoplasms Endometrial stromal sarcoma Papillary renal cell carcinoma Quadruple primary neoplasms Multiple primary malignancies (MPMs) | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Karimi Rouzbahani A, Baharvand Irannia Y, Ahmadi Somaghian S, Mahmoudvand G, Adeli O-A, Yusofvand R. Multiple Primary Metachronous Malignancies, Namely Kidney, Colon, Uterus, and Breast Cancer: A Case Report. CRCP. 2026;10(5):218-223.
