Synchronous quadruple primary malignancies of the cervix, endometrium, ovary, and stomach in a single patient: A case report and review of literature

Table 1 Summary of all existing cases of quadruple synchronous primary malignancies in the English literature (n = 9)

Reference	Year	Age (yr)	Presentation	Sites	Tumor histology	Treatment	Outcome	Follow-up (mo)
author
Phupong et al[11]	2007	50	Menorrhagia	Ovary	Mucinous adenocarci-noma	RT	DOD	3
				Ovary	Low malignant potential
				Uterus corpus	Endometroid adenocarci-noma
				Cervix	Endocervical adenosqua-mous carcinoma
Saglam et al[12]	2008	63	Postmenopau-sal bleeding Abdominal distention	Ovary	Mucinous adenocarcinoma	CT	NED	12
				Fallopian tube	Early papillary adenocarcinoma
				Uterus corpus	Endometroid adenocarcinoma
				Cervix	Endocervical adenosquamous carcinoma
Kim et al[13]	2013	73	Dyspepsia	Thyroid	Papillary carcinoma	ET; CT	DOD	8
				Breast	Invasive ductal adenocarcinoma
				Pancreas	Adenocarcinoma
				Stomach	gastrointestinal stromal tumor (GIST)
Grace et al[14]	2015	70	Aphasia Confusion	Brain	Glioblastoma	Surgery	NM	NM
				Ileum	Neuroendocrine tumor
				Inguinal region	Schwannoma
				Appendix	Sessile serrated adenoma/ polyps
Klairmont et al[15]	2015	74	Right breast lesion	Breast	Invasive ductal carcinoma	Surgery; CT	NM	18
				Esophagus	Adenocarcinoma
				Colon	Adenocarcinoma
				Lung	Squamous cell carcinoma
Maruyama et al[16]	2015	69	Tongue pain	Tongue	Squamous cell carcinoma	Surgery; RT; ET	DFS	60
				Right Breast	Invasive ductal carcinoma
				Left Breast	Intraductal carcinoma
				Kidney	Chromophobe renal cell carcinoma
Meek et al[3]	2016	95	Nausea Vomiting Abdominal distention	Cecum	Adenocarci-noma	Surgery	NM	NM
				Appendix	Sessile serrated adenoma
				Appendix	Neuroendocrine tumor
				Appendix	Schwann cell hamartoma
Nanashima et al[17]	2017	67	Epigastric pain	Stomach	Adenocarci-noma	Surgery; CT	DFS	51
				Colon	Adenocarcinoma
				Rectum	Neuroendocrine tumor
				Pancreas	Papillary ductal adenocarci-noma
Fan et al[18]	2017	53	No discomfort	Stomach	Adenocarci-noma	Surgery; CT	DFS	12
				Stomach	GIST
				Esophagus	Squamous cell carcinoma in situ
				Esophagus	Small cell carcinoma

ET: Endocrinotherapy; CT: Chemotherapy; RT: Radiotherapy; DOD: Died of disease; NED: No evidence of disease; NM: Not mentioned; DFS: Disease free.