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Multiple Primary Malignancies—Challenges in Diagnosis and Management for a Gynecological Oncologist



Multiple primary malignancies in an individual is an uncommon condition, but is increasingly being seen in high volume centers. They could be due a common etiological factor, inherited gene mutations, inherited syndromes, or could simply be an unfortunate coincidence.


To determine the common associations of multiple primary malignancies in relation to the female genital tract, and to determine the hurdles in their diagnosis and management.


All patients having multiple primary malignancies with at least one gynaecological primary during the period 01–07-2019 to 30–06-2021 were studied. Each case was studied to determine the primaries- whether synchronous or metachronous, and if synchronous, whether the diagnosis of the second primary was a surprise/missed finding, and finally, if the management of each case was satisfactory or not.


A total of 13 cases of multiple primary malignancies were detected, out of which 8 cases were synchronous, 4 were metachronous, and one was a case of synchronous and metachronous malignancy. The most common association was that of carcinoma ovary being the first detected primary with that of carcinoma cervix/vault. The diagnosis of the second primary was a surprise in 3 cases. The treatment outcome was satisfactory in only about 6 cases.


The optimal management of multiple primary malignancy depends on effective screening, early diagnosis, and offering risk reduction surgeries to at risk patients. It also involves the utilization of superior imaging, cytological and histological techniques, and better clinical judgement by all the treating oncologists.

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Correspondence to Anirudha Rohit Podder.

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Kumari, A., Podder, A.R. Multiple Primary Malignancies—Challenges in Diagnosis and Management for a Gynecological Oncologist. Indian J Gynecol Oncolog 19, 88 (2021).

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  • Multiple primary malignancies
  • Synchronous malignancies
  • Metachronous Malignancies