Multiple primary malignancies of the colon, stomach, and kidney in a patient with bowel obstruction requiring emergency surgery: A case report

Abstract

Patient: Male, 63-year-old Final Diagnosis: Colon adenocarcinoma Symptoms: Abdominal pain • constipation Medication: — Clinical Procedure: — Specialty: Surgery Objective: Background: Case Report: Conclusions: Rare co-existance of disease or pathology Multiple primary malignancy (MPM) is defined as 2 or more primary malignancies diagnosed in the same pa-tient. Even though MPMs are rare, various associated tumors have been reported in the literature. We report the first case of triple synchronous primary malignancies: gastrointestinal stromal tumor, colon adenocarcino-ma, and renal cell carcinoma. A 63-year-old man presented to our emergency department with a 7-day history of diffuse abdominal pain and constipation. Examination revealed a distended abdomen and diffuse tenderness. Enhanced computed to-mography showed a high-grade large bowel obstruction with the transitional zone seen at the splenic flexure, which was suspicious for primary colon cancer, and a hypodense lesion on the left mid-pole of the kidney. An emergency exploratory laparotomy revealed a splenic flexure mass, which was resected, and a left renal mass, which was excised. A stomach mass at the greater curvature was an incidental intraoperative finding; a wedge resection was performed for it. The pathology for each of the masses showed a primary malignancy. Multiple primary cancers are rare and a multidisciplinary team approach is essential for management of these patients, be it preoperative, intraoperative, postoperative, or long-term surveillance.