A Case Report of a Synchronous Quadruple Cancer -Double Early Gastric Cancers, Early Colonic Cancer, Small Liver Cancer-

Tsuyoshi Gonda, Hideyuki Ishida, Tetsuro Higuchi*, Hiroshi Hirukawa, Hideo Nakajima*, Ikuo Hojo, Yoshio Mishima*

The Department of Surgery, Niigata Prefectural Tokamachi Hospital
*The Second Department of Surgery, Tokyo Medical and Dental University

We report a case of a quadruple cancer (double early gastric cancers, early colonic cancer, small liver cancer) with a review of the literature. A 72-year-old man was admitted to our hospital under the diagnosis of liver cirrhosis, esophageal varices and early gastric cancer. On the secreening examination, a polyp in the sigmoid colon and a hepatic tumor in S₆ were detected. Polypectomy was performed and histological examination showed carcinoma in adenoma. Total gastrectomy (D₂), splenectomy and hepatic subsegmentectomy were performed. The histological examination showed two early gastric cancers (IIa, IIa+IIc; well-differentiated adenocarcinoma). The liver tumor was a well-differentiated hepatocellular carcinoma. There have been only 11 reports of patients with a quadruple cancer undergoing curative management for all cancers. Our case is the only one in which four cancers belonged to a category of early cancer. As the number of patients with multiple primary cancers is increasing, careful examination should be performed with consideration of the possibility of multiple cancers.

Key words
synchronous quadruple cancer

Reprint requests
Tsuyoshi Gonda The Department of Surgery, Niigata Prefectural Tokamachi Hospital
32-9 Takayama, Tokamachi-city, 948 JAPAN

Accepted
January 12, 1994

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