A Resected Case of Synchronous Quadruple Cancers Including Hepatocellular Carcinoma

Naoki Maehara, Kazuo Chijiiwa, Kazuhiro Kondo, Masayuki Hotokezaka, Hideki Hidaka, Naoki Sameshima¹⁾, Kousuke Marutsuka¹⁾, Ichiro Kuwahara²⁾, Ryoichi Hamasuna³⁾ and Yujiro Asada¹⁾

Department of Surgical Oncology and Regulation of Organ Function, First Department of Pathology¹⁾, Department of Radiology²⁾, and Department of Urology³⁾, Miyazaki University School of Medicine

We report a case of synchronous quadruple cancer gastric cancer, hepatocellular carcinoma, renal cell carcinoma, and rectal cancer in a 78-year-old Japanese man. Early gastric cancer was incidentally found on gastroscopyduring a regular physical examination. Liver tumor and a left renal tumor were detected by further examination using US and CT. Upon surgical referral, rectal cancer was detected on colonoscopy. After endoscopic submucosal dissection of the stomach for early gastric cancer, left lobectomy of the liver, abdominoperineal resection and left nephrectomy in a three-stage operation, histological examination showed quadruple cancer well-differentiated gastric adenocarcinoma, hepatocelluler carcinoma, well-differentiated rectal adenocarcinoma, and left renal cell carcinoma. Since synchronous quadruple cancers including hepatocellular carcinoma is extremely rare, we report this case and review the literature.

Key words
synchronous, quadruple cancer, hepatocellular carcinoma

Reprint requests
Kazuo Chijiiwa Department of Surgical Oncology and Regulation of Organ Function, Miyazaki University School of Medicine
5200 Kihara, Kiyotake, Miyazaki, 889-1692 JAPAN

Accepted
May 21, 2008

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