Objective: When more than one primary tumor presents in the same patient, multiple
primary malignancies (MPMs) are diagnosed. The incidence of MPMs has increased due to the
progress in diagnosis and treatment of malignant tumors. MPMs are a clinical situation defined as the
diagnosis of more than one histologically proven tumor within the same patient. The recent advances
in diagnostic modalities, treatment, in addition to the cancer screening programs led to a substantial
rise in the incidence of MPMs. Management of patients with MPMs is highly challenging and highlights
the role of multidisciplinary tumor board management.
Patients and Methods: This report represents the clinicopathological features of 8 patients
with MPMs from 2018 to 2021. We used Warren and Gate’s criteria of classification of MPMs as
synchronous or metachronous.
Results: A total of 2145 patients with malignant tumors presented to our Department from 2018
to 2021, while cases with histologically proven MPMs represented (0.37%) of the total cohort of patients.
The mean age of the patients was 59.87 years. The male to female ratio was 1:1 (Figure 1). Solid
tumors were the predominate in 6 cases (75%) as the first tumor, and as the second one in 7 patients
(87.5%), while hematological tumors presented only in 2 cases (25%) as the first primary tumor and
in 1 patient (12.5%) as the second tumor (Figure 2, 3). Hodgkin Disease (HD) and breast cancer represented
the most common primary tumors in (50%) and (25%) cases, respectively, while breast cancer
was diagnosed as a second tumor in (25%) of the patients. Metachronous MPMs constituted (75%) of
cases, while 25% of cases were synchronous (Figure 4, 5).
Conclusions: The MPMs are proven not to be a rare diagnosis and is forecasted to show a steady
increase in the incidence based on the progress in the diagnostic procedures. Meticulous follow up and
the tackling of patients’ symptoms are imperative in the early detection and proper management.