Abstract
A 77-year-old woman was referred to our hospital because of gastric cancer with epigastralgia and anemia. Thoraco-abdominal contrast-enhanced CT scan showed wall thickening of the transverse colon, a tumor shadow in the left upper lung field and a right breast tumor. We confirmed the diagnosis of gastric cancer and colon cancer by biopsies using endoscopy. Needle aspiration biopsy cytology revealed breast cancer. The tumor shadow in the left upper lung field was diagnosed radiologically with adenocarcinoma. But observation of the clinical course was employed for the lung lesion by the patient's request. Distal gastrectomy and transverse colectomy were performed in November 2008. Right mastectomy and axillary lymph nodes dissection were performed in March 2009. After an 18-month course observation, the lung tumor was recognized to grow. Left upper lobectomy of the lung was thus performed in May 2010. Histologically, the gastric tumor was well differentiated adenocarcinoma, the colon tumor was well differentiated adenocarcinoma, the breast tumor was scirrhous carcinoma, and the lung tumor was adenocarcinoma with mixed subtype. So curative resections were achieved for synchronous quadruple cancer. She has been well without any signs of recurrence for 3 years after the first operation.
