Synchronous quadruple primary tumors of thyroid, breast, pancreas, and stomach: a case report

We herein present the first case to be reported of synchronous quadruple primary cancer of the thyroid, breast, pancreas and stomach in a 70-year-old female. Fluorine-18-fluorodeoxyglucose (FDG)-positron-emission tomography/computed tomography (PET/CT) revealed increased FDG activity in the thyroid, left breast, pancreatic body and antrum of the stomach. To make a definitive diagnosis of synchronous quadruple primary tumors, ultrasound-guided fine-needle aspiration (FNA) cytology and biopsy of the thyroid, breast, pancreas and stomach were performed. FNA cytology and biopsy findings showed papillary carcinoma of the thyroid, invasive ductal adenocarcinoma of the breast, adenocarcinoma of the pancreas and gastrointestinal stromal tumor. To the best of our knowledge, this combination of synchronous multiple primary tumors has not been reported.