Synchronous malignancies in a postmenopausal woman: A case of cervical and breast cancer

Synchronous primary malignancies are uncommon but increasingly identified due to advanced imaging techniques like positron emission tomography–computed tomography (PET-CT). The coexistence of breast and cervical cancers is particularly rare, given their distinct etiologies – hormonal and genetic factors in breast cancer versus persistent human papillomavirus infection in cervical cancer. We present the case of a 69-year-old postmenopausal woman who reported vaginal discharge. Clinical and radiological evaluation revealed a locally advanced cervical tumor, confirmed as nonkeratinizing squamous cell carcinoma. PET-CT performed for staging incidentally detected a fluorodeoxyglucose-avid lesion in the right breast. Subsequent biopsy confirmed a Grade II, estrogen and progesterone receptor-positive, Human Epidermal Growth Factor 2 Receptor (HER2)-negative infiltrating ductal carcinoma. There was no axillary nodal involvement. A multidisciplinary tumor board recommended a right mastectomy with sentinel lymph node biopsy to avoid radiation overlap, followed by concurrent chemoradiotherapy for the cervical cancer. Postoperatively, the patient received 45 Gy of external beam radiotherapy with weekly cisplatin, followed by brachytherapy. She was started on adjuvant endocrine therapy for breast cancer and remains under regular follow-up. This case underscores the importance of comprehensive imaging in cancer evaluation, particularly when clinical findings are atypical. The detection of synchronous tumors can significantly alter treatment planning and prognosis. A multidisciplinary, individualized approach is essential to optimize outcomes in such complex scenarios.