Double Troubles – Managing a Series of Cases with Dual Primary Malignancies

A BSTRACT The reported incidence of multiple primary malignant tumor (MPMT) is between 0.734% and 11.7%. Double primary malignancy is the occurence of second primary malignant tumor of another organ in patients with a known malignant tumor. We present four cases with dual primary malignancy and treatment of these dual malignancies. All patients who underwent surgical treatment for cancers between April 2020 and April 2024 were reviewed, and the patients who had dual primary malignant tumors were identified. Hereby, we share our experience regarding multiple primary malignant tumors, their initial clinical presentation, treatment given, and outcomes. Out of the total of 386 patients with cancer who were treated in our teaching hospital in the surgical oncology department from April 2020 to December 2023, four patients had synchronous dual malignancies (1.03%). One patient underwent surgery for dual malignancy. Two patients underwent surgery for first primary cancer and chemotherapy/radiotherapy for second primary cancer. One patient underwent orchidectomy for carcinoma prostate, which is primary tumor, and chemotherapy for second primary tumor (rectal malignancy). Patients diagnosed with hereditary syndromes should be categorized under separate registry and followed up more frequently than the routine population. At present, there is no specific treatment protocol of MPMT and many of the treating surgeons and physicians rely on cases reported. Hence, forming a cancer registry for MPMTs can be considered as there are a variety of combinations of MPMTs. Hence, such cancers can be diagnosed and treated early.