Multiple cancers of the large bowel

Abstract

MULTIPLE CANCERS Of the large bowel were reported in the medical literature before the turn of the century. In 1880, CzernyS reported the first case, and in 1888 another case was presented by Fenger.S Several other case reports appeared sporadically, and then in 1930 Bargen and Rankin 2 collected I6 cases and warned tile profession that one malignancy in the colon did not confer immt}nity, but rather the physician should be alert to the possible presence of concurrent or subsequent lesions. By 1957, 774 cases of multiple cancers of the colon had been described in the literature, and in 1958 Moertel, Bargen, and Dockerty ~0 reviewed the cases of 6,000 patients with carcinoma of the colon and rectum at the Mayo Clinic and found 261 involving multiple lesions, either concurrent or recurrent in nature. in the majority of reported cases of multiple cancers the patients had two Iesions. Tt~ere were a few reports of three lesions~, a. 6, 9 and two reports of four lesions.Z, x2 We would like to present three cases of triple lesions and one case with four which we feel fulfill the criteria for primary malignant lesions set forth by Warren and Gates, 14 who said, "Each of these tumors must present a definite picture of malignancy; each must be distinct, and the possibility of one being a metastasis of the o~her mus~ be exciuded."