A Case of Metachronous Quadruple Cancer Confined to the Gastrointestinal Tract

Hitoshi Yasui, Masahiro Shimizu, Akira Yamada, Tomoyuki Maeda, Yoshinori Kobayashi

Department of Surgery, Aiseikai Yamashina Hospital

We report a case of resectable metachronous quadruple cancer which was confined to the gastrointestinal tract (cancer of the ascending colon, early gastric cancer, rectal cancer and cancer of the remaining stomach) during an l8-year period. The patient was a 75-year-old man. For each cancer a radical operation was performed (right hemicolectomy, distal gastrectomy, abdominoperineal excision of the rectum and total excision of the remaining stomach). Thereafter, the patient showed no recurrence. These four cancers were detected during long-term follow-up of chronic diseases, and could be surgically treated in the relatively early stage. In this case a particular factor responsible for the multiple cancers could not be found. Up to now 107 cases of quadruple and quintuple cancers have been reported in Japan. In 15 of these cases the cancers were confined to the gastrointestinal system. In our statistical survey of multiple cancers in autopsied cases, the incidence of multiple cancers in the total cases of malignant neoplasms has doubled over the past 10 years, and the level of multiplicity has been high. Therefore, attention should be paid to multiple cancers before and after surgery.

Key words
multiple cancer, metachronous quadruple cancer, gastrointestinal tract

Reprint requests
Hitoshi Yasui The Second Department of Surgery, Kyoto Prefectural University of Medicine
465 Kawaramachi, Hirokoji, Kajii-cho, Kamikyo-ku, Kyoto, 602 JAPAN

Accepted
September 12, 1990

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