Synchronous malignancies of ovary, fallopian tube and cervix- A rare case

Abstract

Multiple primary tumours may either be synchronous or metachronous tumours, depending on the timing of diagnosis of the different primary tumours. Synchronous gynecological tumors are rare and are frequently double primaries involving ovary and endometrium. Triple synchronous primary malignancies are even rarer and carry a diagnostic and therapeutic challenge to a pathologist and oncologist, respectively. Theories on etiopathogenesis are presented. This case is presented for its rarity and interesting pathogenesis. We are presenting a rare case of triple synchronous primary malignancies originating in the uterine cervix, fallopian tube and ovary. An elderly female of 55yrs underwent panhysterectomy for Squamous cell carcinoma cervix, diagnosed on pap smear and tubo-ovarian mass, picked up on ultrasound examination. On histopathologic examination a diagnosis of Primary papillary cystadenocarcinoma ovary and fallopian tube with synchronous adenosquamous carcinoma cervix was made. Multiple primary neoplasms of female genital tract is a well-recognized yet rare occurrence. Field cancerization is a concept that was suggested by Slaughter et al.7 in 1953 which suggests that when the body is exposed to carcinogens, other organs besides the organ with cancer are also exposed to the carcinogen and carry a high risk of cancer. Although the presented case is probably an incidental event, the pathogenesis of the neoplastic process affecting the tissues with common embryological origin needs further research and evaluation. It is important to distinguish multiple primary neoplasms from metastatic disease because of the fact that overall survival as well as treatment would vary considerably.