Gynecological Coevality: Synchronous Tumors

Background: Two or more unrelated primary malignant tumors that develop from distinct organs are referred to as synchronous tumors.Female genital tract synchronous tumors are rare.Synchronous malignancies account for 1.7% of all female genital cancers, with cancer antigen (CA) endometrium and CA ovary being the most prevalent combination.However, only around 5% of endometrial cancers and 10-20% of ovarian cancers manifest as concurrent cancers of the uterus and ovaries, respectively.Identifying the difference between independent primary tumors and metastasis between the endometrium and ovary, or vice versa, can be challenging but is clinically important, as is reflected in this article.Our experience: We present our experience in managing four such cases of synchronous tumors over a span of 3 years.The first patient was a postmenopausal lady who presented with postmenopausal bleeding (PMB).On evaluation, it was found to have carcinoma of the endometrium on endometrial biopsy with a coexistent ovarian mass, which turned out to be a synchronous tumor, endometrioid adenocarcinoma of the endometrium, and borderline mucinous tumors of both ovaries on the final histopathology.The second patient was a perimenopausal lady with a large ovarian mass with a history of heavy menstrual bleeding (HMB) and was found to have synchronous ovarian (mucinous cystadenocarcinoma) and endometrial malignancy (endometrioid adenocarcinoma) on the final histopathology.The third patient was a postmenopausal lady with PMB who had synchronous carcinoma of the endometrium (endometrioid adenocarcinoma) with granulosa cell tumor of the ovary.The last patient was postmenopausal, who came with PMB and turned out to have coexistent carcinoma endometrium (carcinosarcoma) with highgrade clear cell carcinoma of the ovary.Conclusion: It is imperative to distinguish synchronous malignancies from metastatic tumors of the same primary source, as this would change the treatment protocol for the patient and would also affect the final outcome of the patient.