Sychronous Quadruple Cancers of Rectum and Sigmoid Colon. A Case Report.

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A 64-year-old male was admitted to our hospital with a diagnosis of ileus due to colon cancer. He had no colon cancer in the family history. A barium enema study showed four lesions: a large elevated mass in the Rs region, a site of severe stenosis proximal to it, a small filling defect and a more proximal site of complete obstruction in the S region with the first lesion being closest to and the last region farthest away from the anus. Colon fiberscopy showed a type 1 tumor 20cm from the anus but no further observation was possible beyond this region. High anterior resection was performed and the specimen showed synchronous quadruple cancers of the rectum and sigmoid colon. The lesions were classified macroscopically to be type 1, type 2, type I p, and type 1 with the first one closest to and the last one farthest away from the anus. Microscopically, they were all well-differentiated adenocarcinoma but were separate from each other. The depths of the tumors were pm, ss, sm and pm, which means that three were advanced and one, early cancer. Analysis of the DNA ploidy patterns of the tumor tissues showed that the lesions were probably aneuploidy, diploidy, diploidy and diploidy. No evidence which support transluminal metastasis of the four tumors was obtained in this patient. No recurrence appeared in the follow up period of 2 years and 10 months.
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