A Resected Case of Synchronous 4 Primary Carcinomas -Carcinomas of the Pharynx the Larynx, the Esophagus, and the Stomach-

Ryuichiro Ohashi, Wataru Takiyama, Shigemitsu Takashima, Koichi Mandai*

Department of Surgery and Department of Pathology*, Shikoku Cancer Center Hospital

We report a case of four resectable synchronous primary cancers, i.e., carcinomas of the lower pharynx, larynx, esophagus, and stomach. The patient was a 66-year-old man with bloody sputum. Two white elevated lesions were found in the lower pharynx and the larynx by laryngofiberscopy. Using upper gastrointestinalfiberscopy, a superficial elevated lesion in the lower thoracic part of the esophagus and an elevated lesion with irregular surface in the greater curvature of the stomach were also detected. We performed lower pharyngectomy, laryngectomy, total esophagectomy, and proximal partial gastrectomy. Microscopic examination revealed the lesions of the lower pharynx, larynx, and esophagus were moderately differentiated squamous cell carcinomas. The esophageal cancer was limited to the submucosal layer, and the carcinoma of the larynx invaded to the cartilage with cervical nodal involvement. Ten multiple primary cancers were detected in these organs. The lesion of the stomach was welldifferentiated adenocarcinoma, limited to the submucosal layer, without nodal involvement. Carcinogenic factors, such as smoking, were reported to be similar between esophageal cancer and head and neck cancer. Therefore, careful management should be given to these cancer patients.

Key words
synchronous cancer, quadruple cancer, cancer of upper alimentary tracts

Reprint requests
Ryuichiro Ohashi Department of Surgery, Shikoku Cancer Center Hospital
13 Horinouchi, Matsuyama, 790 JAPAN

Accepted
September 8, 1993

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