An in-depth investigation of synchronous multiple primary tumours (multicentric and bivalent) in the pancreas and colon

Abstract

Introduction. Multiple primary synchronous malignancy refers to the development of multiple cancerous growths in one or more organs, which are identified within a timeframe of 2-6 months (according to SEER-IARC/IARC). The diagnostic criteria suggested by Warren and Gates hold significant importance. Case statement. The intricate macroscopic surgical specimen from a 56-year-old patient was analyzed. The pancreatoduodenal complex includes a tumour located at the pancreatic head, measuring 4 cm with a star-like shape. The tumour has infiltrated the muscular layer of the duodenal wall, peripancreatic adipose tissue, and extends up to 2 mm from the surgical resection margin. The second tumour in the ascending colon exhibits an ulcerative-infiltrative appearance, it is 9 cm in size. The third tumour in the sigmoid colon displays an ulcerative-infiltrative appearance, with a size of 2 cm. The histological examination shows the presence of several synchronous multicentric and bivalent primary tumours in the ascending and sigmoid colon, as well as the pancreas. A poorly differentiated ductal adenocarcinoma in the pancreas. In the ascending colon, there is a mucinous adenocarcinoma with signet ring cells. In the sigmoid colon, there is a submucosal adenocarcinoma, moderately differentiated. From a clinical perspective, the patient exhibits symptoms of overall debility, body weight loss and jaundice. Discussions. The prevalence of diagnosing multiple main tumours has markedly risen from the early studies, ranging from 2.4% to 17% in the past two decades. Conclusion. The existence of several primary tumours, whether occurring simultaneously or at different times, highlights the intricate and diverse nature of cancer presentations. The management of multiple tumours presents diagnostic and therapeutic problems that necessitate a personalised and multidisciplinary approach. cancerous growths in one or more organs, which are identifi ed within a timeframe of 2-6 months (according to SEER-IARC/IARC). The diagnostic criteria sugges ted by Warren and Gates hold significant importance. Case statement. The intricate macroscopic surgical specimen from a 56-y ear-old patient was analyzed. The pancreatoduodenal complex includes a tumour lo cated at the pancreatic head, measuring 4 cm with a star-like shape. The tumour has infil trated the muscular layer of the duodenal wall, peripancreatic adipose tissue, and extends up to 2 mm from the surgical resection margin. The second tumour in the ascending colon exhibits an ulcerative-infiltrative appearance, it is 9 cm in size. The third tumour in the sigmoid colon displays an ulcerative-infiltrative appearance, with a size of 2 cm. The histological examinati on shows the presence of several synchronous multicentric and bivalent primary tumours in the ascending and sigmoid colon, as well as the pancreas. A poorly differentiated ductal adenoca rcinoma in the pancreas. In the ascending colon, there is a mucinous adenocarcinoma with signet ring cells. In the sigmoid colon, there is a submucosal adenocarcinoma, moderately different iated. From a clinical perspective, the patient exhibits symptoms of overall debility, body weight lo ss and jaundice. Discussions. The prevalence of diagnosing multiple main tumours has mar kedly risen from the early studies, ranging from 2.4% to 17% in the past two decades. Conclusion. The existence of several primary tumours, whether occurri ng simultaneously or at different times, highlights the intricate and diverse natur e of cancer presentations. The management of multiple tumours presents diagnostic and t herapeutic problems that necessitate a personalised and multidisciplinary approach.