Dual Gynecological Malignancies: A Case Series from Tertiary Care Center

  • Sonal Patel
  • Mridul AnandEmail author
Original Article



A literature review on 1,104,269 cancer patients concluded that the prevalence of multiple primary malignancies is between 0.73 and 11.7%. The lifetime risk of developing another de novo primary after being detected with cancer is high. We report synchronous and metachronous double malignancy cases presenting in Radiotherapy Department in the Gynecology Oncology subspeciality in our hospital.


A prospective observational study was carried in our Department of Radiation Oncology over a period of 3 years. A total of 25 patients reported with multiple primary cancers from 2015 to 2018.


Out of 25 patients, nine patients were with synchronous presentations and the rest were with metachronous presentations. Each had a different line of management, and they were dealt with individually according to their origin of primary cancer and stage.


The incidence of multiple primary cancers is on the rise, and the possibility of the same should be considered in the pretreatment evaluation. Screening procedures and careful monitoring should be done to ensure early detection and appropriate management.


Double primary cancers Dual malignancy Carcinoma cervix with carcinoma ovary Synchronous cancers Metachronous malignancy 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Vaslamatzis M, Alevizopoulos N, Petraki C et al. Second primary neoplasms (SPN) in cancer patients. In: Proceedings of ASCO2003, vol 22, p. 3581.Google Scholar
  2. 2.
    Morgenfeld EL, Tognelli F, Gil Deza E, et al. Synchronous and metachronous second (ST) and third (TT) primary tumors (PT) in a large patient population. Proc ASCO. 2003;22:3152.Google Scholar
  3. 3.
    Suzuki T, Takahashi H, Yao K, Inagi K, Nakayama M, Makoshi T, et al. Multiple primary malignancies in the head and neck: a clinical review of 121 patients. Acta Otolaryngol Suppl. 2002;547:88–92.CrossRefGoogle Scholar
  4. 4.
    Ferreti Sea. Airtum cancer registration handbook, 2009.Google Scholar
  5. 5.
    Warren S, Gates O. Multiple primary malignant tumors: a survey of the literature and statistical study. Am J Cancer. 1932;16:1358–414.Google Scholar
  6. 6.
    Moertel CG, Dockerty MB, Baggenstoss AH. Multiple primary malignant neoplasms. II. Tumors of different tissues or organs. Cancer. 1961;14:231–7.CrossRefGoogle Scholar
  7. 7.
    Curtis RE, Freedman DM, Ron E, Ries LA, Hacker DG, Edwards BK, et al., editors. New Malignancies among cancer survivors: SEER cancer registries, 1973–2000. Bethesda: National Cancer Institute; 2006. p. 9–14.Google Scholar
  8. 8.
    Morris LG, Sikora AG, Hayes RB, Patel SG, Ganly I. Anatomic sites at elevated risk of second primary cancer after an index head and neck cancer. Cancer Causes Control. 2011;22(5):671–9.CrossRefGoogle Scholar
  9. 9.
    Woodruff JD, Solomon D, Sullivant H. Multifocal disease in the upper genital canal. Obstet Gynecol. 1985;65:695–8.PubMedGoogle Scholar
  10. 10.
    Lauchlan SC. The secondary Müllerian system. Obstet Gynecol Surv. 1972;27:133–46.CrossRefGoogle Scholar
  11. 11.
    Deligdisch L, Szulman AE. Multiple and multifocal carcinomas in female genital organs and breast. Gynecol Oncol. 1975;3:181–90.CrossRefGoogle Scholar
  12. 12.
    Eisner RF, Nieberg RK, Berek JS. Synchronous primary neoplasms of the female reproductive tract. Gynecol Oncol. 1989;33:335–9.CrossRefGoogle Scholar
  13. 13.
    Escobar PA, Smith MT, Vasishta A, Hubbard AE, Zhang L. Leukaemia-specific chromosome damage detected by comet with fluorescence in situ hybridization (comet-FISH). Mutagenesis. 2007;22(5):321–7.CrossRefGoogle Scholar
  14. 14.
    Horii A, Han HJ, Shimada M, Yanagisawa A, Kato Y, Ohta H, et al. Frequent replication errors at microsatellite loci in tumors of patients with multiple primary cancers. Cancer Res. 1994;54(13):3373–5.PubMedGoogle Scholar
  15. 15.
    Prat J, Matiasguiu X, Barreto J. Simultaneous carcinoma involving the endometrium and the ovary: a clinicopathological, immunohistochemical, and DNA flow cytometric study of 18 cases. Cancer. 1991;68:2455–9.CrossRefGoogle Scholar
  16. 16.
    Dragoumis K, Zafrakas M, Venizelos I, et al. Synchronous primary neoplasms of the uterine corpus and the ovary: a case report. Eur J Gynaecol Oncol. 2004;25:752–4.PubMedGoogle Scholar
  17. 17.
    Simpkins F, Zahurak M, Armstrong D, et al. Ovarian malignancy in breast cancer patients with an adnexal mass. Obstet Gynecol. 2005;105:507–13.CrossRefGoogle Scholar
  18. 18.
    Passman MA, Pommier RF, Vetto JT. Synchronous colon primaries have the same prognosis as solitary colon cancers. Dis Colon Rectum. 1996;39:329–34.CrossRefGoogle Scholar
  19. 19.
    Tamura M, Shinagawa M, Funaki Y. Synchronous triple early cancers occurring in the stomach, colon and gallbladder. Asian J Surg. 2003;26:46–8.CrossRefGoogle Scholar
  20. 20.
    Van Dalen R, Church J, McGannon E, Fay S, Burke C, Clark B. Patterns of surgery in patients belonging to Amsterdam-positive families. Dis Colon Rectum. 2003;46:617–20.CrossRefGoogle Scholar
  21. 21.
    Ayhan A, Guvenal T, Coskun F, Basaran M, Salman MC. Survival and prognostic factors in patients with synchronous ovarian and endometrial cancers and endometrial cancers metastatic to the ovaries. Eur J Gynaecol Oncol. 2003;24:171–4.PubMedGoogle Scholar
  22. 22.
    Oya M, Takahashi S, Okuyama T, Yamaguchi M, Ueda Y. Synchronous colorectal carcinoma: clinico-pathological features and prognosis. Jpn J Clin Oncol. 2003;33:38–43.CrossRefGoogle Scholar
  23. 23.
    Carmichael AR, Bendall S, Lockerbie L, Prescott R, Bates T. The long-term outcome of synchronous bilateral breast cancer is worse than metachronous or unilateral tumours. Eur J Surg Oncol. 2002;28:388–91.CrossRefGoogle Scholar

Copyright information

© Association of Gynecologic Oncologists of India 2019

Authors and Affiliations

  1. 1.Gujarat Cancer Research Institute (G.C.R.I.)AhmedabadIndia

Personalised recommendations