A Case Report of Asynchronous Multiple Cancers Including Quadruple Colon Cancers, Gastric Cancer, Renal Cell Carcinoma and Rectal Cancer

A case of asynchronous multiple cancers including quadruple colon cancers, gastric cancer, renal cell carcinoma, and rectal cancer is described. The patient, a 57-year-old woman, was diagnosed as having transverse colon cancer at the age of 36 in 1970. In 1984 sigmoid colon cancer, transverse colon cancer, gastric cancer and renal cell carcinoma were found simultaneously. The rectal cancer was revealed in 1991, and the seventh cancer developed in the transverse colon in 1994. All carcinomas were resected radically. No sign of recurrence or metastasis has been seen since the last operation. Replication errors in DNA, which may play an important role in development of multiple primary cancers, were observed in the seventh tumor. The patient should be considered to have an increased risk of an additional primary cancer.