A Case Report of Heterochronous Multiple Cancers Including Quadruple Colon Cancers and A Early Gastric Cancer

Naoki Asakage, Yûichi Tomiki, Yasuo Hayashida, Noburu Sakakibara, Shû Hirai*

First Department of Surgery, Juntendo Universiyt School of Medicine
*First Department of Pathology, Juntendo University School of Medicine

The patient is a 90-year-old woman. The first cancer developed in the ascending colon and right hemicolectomy was performed in 1987. Its histological diagnosis was type 2, mucinous carcinoma. The 2nd cancer, which developed in the Rb portion of the rectum, was histologically well-differentiated adenocarcinoma of type 2. The 3rd cancer was observed in the R_s portion of the rectum. It was a carcinoma in adenoma of I_sp type. Low anterior resection of the rectum was performed on the 2nd and 3rd cancers in l984. The 4th cancer was a II_c type early gastric cancer of well-differentiated tubular adenocarcinoma. The progress of the 4th cancer has been observed since 1986 up to May 1991 without an operation. The 5th cancer was detected in the transverse colon and partial resection of the transverse colon was performed in 1989. Its histological diagnosis was type 2, well-differentiated adenocarcinoma. The incidence of primary multiple cancers is on the increase with development of diagnostic techniques, improvement of therapeutic results and prolongation of the average life span. Recently we experienced a patient presently under observation for an early gastric cancer, who had heterochronous multiple cancers of the digestive tract for the past 16 years and received surgical treatment for cancers of the ascending colon, rectum and transverse colon. As reports of heterochronous multiple cancers including quadruple colon cancers and early gastric cancer are quite rare, our case will be presented and discussed with a literature review.

Key words
multiple primary malignant tumors, heterochronous cancers

Reprint requests
Naoki Asakage First Department of Surgery, Juntendo University School of Medicine
3-1-3 Hongo, Bunkyo-ku, Tokyo, 113 JAPAN

Accepted
December 10, 1991

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