SYNCHRONOUS GASTRO-INTESTINAL MALIGNANCIES - A CASE SERIES

The occurrence of multiple gastrointestinal cancers in the same patient was previously thought to be extremely rare. But with advancements in investigative modalities and with greater implementation of screening programs, the occurrence of synchronous Gastro-intestinal cancers is being increasingly recognised. Apart from it being a diagnostic oddity, the importance of a synchronous primary is that the diagnosis alters the prognosis and management of the patient considerably. In this case series, we report three cases of synchronous cancers, where both the first and the second primary cancers were found in the gastrointestinal tract. Case 1 65 year old Male presented to us with history of recurrent stale food vomiting and dysphagia. He was diagnosed to have synchronous oesophageal and gastric cancers. The oesophageal cancer was poorly differentiated squamous cell carcinoma and the gastric malignancy was a moderately differentiated adenocarcinoma. Case 2 70 year old lady presented with symptoms of gastric-outlet obstruction and dyschezia. She was found to have synchronous gastric and rectal cancer. The gastric cancer was a poorly differentiated adenocarcinoma and the rectal malignancy was a well differentiated adeno-carcinoma. Patient had omental deposits at presentation. Case 3 59 year old male presenting with dysphagia, was found to have dual oesophageal cancers. One lesion was well differentiated while the other was a poorly differentiated squamous cell carcinoma. Each of the cancers was symptomatic and in all three patients curative management was not possible, since the cancers were advanced. We suggest screening upper GI endoscopy in those with colorectal cancers and vice-versa, so that synchronous GI cancers can be diagnosed at an early stage, thereby making curative treatment options feasible.