Kim SH, Park BS, Kim HS, Kim JH. Synchronous quintuple primary gastrointestinal tract malignancies: Case report. World J Gastroenterol 2017; 23(1): 173-177 [PMID: 28104993 DOI: 10.3748/wjg.v23.i1.173]
Corresponding Author of This Article
Byung-Soo Park, MD, Department of Surgery, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan, Gyungsangnam-do 50612, South Korea. colonsurgeon@naver.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jan 7, 2017; 23(1): 173-177 Published online Jan 7, 2017. doi: 10.3748/wjg.v23.i1.173
Synchronous quintuple primary gastrointestinal tract malignancies: Case report
Soo-Hong Kim, Byung-Soo Park, Hyun Sung Kim, Jae Hun Kim
Soo-Hong Kim, Byung-Soo Park, Hyun Sung Kim, Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Gyungsangnam-do 50612, South Korea
Jae Hun Kim, Department of Surgery, Pusan National University Hospital, Busan 602-739, South Korea
Author contributions: Kim SH and Park BS designed the report; Kim HS and Kim JH collected the patient’s clinical information; Park BS analyzed the patient’s data; Kim SH wrote the paper.
Institutional review board statement: The case report was exempt from institutional review board of the Pusan National University Yangsan Hospital.
Informed consent statement: The patient provided informed written consent prior to the treatment.
Conflict-of-interest statement: All the authors have no conflicts of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Byung-Soo Park, MD, Department of Surgery, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan, Gyungsangnam-do 50612, South Korea. colonsurgeon@naver.com
Telephone: +82-55-3602124 Fax: +82-55-3602154
Received: September 9, 2016 Peer-review started: September 12, 2016 First decision: September 28, 2016 Revised: October 5, 2016 Accepted: October 30, 2016 Article in press: October 31, 2016 Published online: January 7, 2017
Abstract
Multiple primary malignancy is defined as two or more malignancies detected in an individual person. In particular, synchronous quintuple primary malignancy is extremely rare. A 52-year-old male with anal pain and intermittent blood-tinged stool was diagnosed with malignancies in the stomach, jejunum, ascending colon, transverse colon and rectum. He underwent a subtotal gastrectomy, segmental resection of the jejunum and total protocolectomy with end ileostomy. The postoperative pathologic findings were moderate differentiated gastric adenocarcinoma (pT1bN0M0, pStageIA), combined adenocarcinoma and neuroendocrine carcinoma of the jejunum (pT3N0M0, pStageIIA), three mucinous adenocarcinoma of the ascending colon (pT3N0M0, pStageIIA), transverse colon (pT1N0M0, pStageI) and rectum (pT3N1aM0, pStageIIIB). The tumors did not lack MLH-1 and MSH-2 expression, as the markers (bat26, D5S346, bat25, D2S123) suggest MSI-H presence. Adjuvant chemoradiotherapy was started according to regimen, FOLFOX 4 for advanced rectal cancer. Six years post-operation, the patient is currently attending regular follow-ups without recurrence or metastasis.
Core tip: We have experienced a case of synchronous quintuple primary gastrointestinal tract malignancies. Reports on synchronous quintuple primary malignancies are extremely rare. Hence, we report on the case, which developed in the stomach, jejunum, ascending colon, transverse colon and rectum with literature review.
