Title: Triple Synchronous Primary Malignancies of Ovary, Endometrium and Cervix – A Rare Case Report

Authors: Dr Milap Shah, Dr Ambreen Aman, Dr Bharat Vaswani, Dr B J Rajesh, Dr CN Sreekanth

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i7.04

Abstract

Synchronous primary malignancies of the female genital tract are rare. Of the reported cases, the more common synchronous cancers are those involving the ovary and endometrium. Three primary malignancies occurring simultaneously are even fewer. We found only 14 such reported cases in pub-med indexed journals till date. The single most important criterion to call these neoplasms synchronous malignancies is that they should be histologically distinct and separated from each other by normal intervening tissues, with no evidence of metastasis. The prognosis for synchronous tumors is relatively better as concurrent tumors are detected early and are associated with a low histological grade.

We are presenting a case report of a 36 year old woman who underwent surgery for complex left ovarian cyst. Intra-operative frozen section analysis of the ovarian cyst proved to be positive for malignancy. Histopathological examination of subsequent staging laparotomy specimen revealed co-existing small cell carcinoma of the ovary, well differentiated endometrioid adenocarcinoma of endometrium, and squamous cell carcinoma-in-situ of the cervix. To the best of our knowledge, simultaneous presentation of these three distinct histological patterns of gynaecological malignancies has not been reported earlier.

Keywords: Synchronous primary malignancies, small cell carcinoma of ovary, endometrioid adenocarcinoma of endometrium, carcinoma-in-situ of cervix.

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Corresponding Author

Dr Milap Shah

MD (Pathology), Senior Consultant Pathologist,

Yashoda Hospital, Secunderabad