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The report describes a 71-year-old man with hepatitis B and a family history of breast and endometrial cancers who developed four coexisting primary malignancies. A multidisciplinary team coordinated diagnostic and therapeutic decisions. The authors emphasize that simultaneous occurrence of these four cancers has not been previously reported and discusses the need for clear definitions, incidence characterization, further work-up strategies, and treatment guidance.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/an-unusual-occurrence-of-multiple-primary-malignant-neoplasms-a-case-report-and-narrative-review/331042/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/an-unusual-occurrence-of-multiple-primary-malignant-neoplasms-a-case-report-and-narrative-review/331042.png","ImageObject",300,407,{"name":92,"@type":93},"Liam","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-23","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What are multiple primary malignant neoplasms (MPMNs) and how are they classified?","Question",{"text":112,"@type":113},"MPMNs are two or more primary malignant tumors, each showing a distinct pathological type from different tissues or organs. They are categorized as synchronous or metachronous based on the interval between diagnoses.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What four primary cancers were identified in the presented patient?",{"text":117,"@type":113},"The case includes basosquamous carcinoma of the nasal tip, prostatic adenocarcinoma, hepatocellular carcinoma, and clear cell renal cell carcinoma.",{"name":119,"@type":110,"acceptedAnswer":120},"Why is the case considered unusual in the literature?",{"text":121,"@type":113},"The authors state that the synchronization of these four primary cancers has never been reported in the literature, while MPMNs in general are increasingly recognized and require proper explanation and guidance.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},331042,1790134898,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":46},8796095461564,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","TYPE Case Report  \nPUBLISHED 17 July 2024  \nDOI 10.3389/fonc.2024.1381532  \nOPEN ACCESS  \nEDITED BY  \nMarco Materazzo, Policlinico Tor Vergata, Italy  \nREVIEWED BY Yufang Zuo,  \nGuangdong Medical University, China Flavio Tirelli,  \nAgostino Gemelli University Polyclinic (IRCCS), Italy  \n*CORRESPONDENCE Wadee Barbarawi  \n [drwadeebar@gmail.com](drwadeebar@gmail.com)  \nRECEIVED 03 February 2024  \nACCEPTED 26 June 2024  \nPUBLISHED 17 July 2024  \nCITATION  \nSalhab RQ, Ghazaleh ZI, Barbarawi W, Salah-Aldin R, Hour H, Sweity R and Bakri IA (2024) An unusual occurrence  \nof multiple primary malignant neoplasms: a case report and narrative review.  \nFront. Oncol. 14:1381532 .  \ndoi: 10.3389/fonc.2024.1381532  \nCOPYRIGHT  \n© 2024 Salhab, Ghazaleh, Barbarawi,  \nSalah-Aldin, Hour, Sweity and Bakri. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.  \nFrontiers in Oncology  \nAn unusual occurrence of multiple primary malignant neoplasms: a case report and narrative review  \nRawand Qasim Salhab 1, Zeina Ihab Ghazaleh 1, Wadee Barbarawi 2*, Riyad Salah-Aldin 2, Hani Hour 3, Raghad Sweity 1 and Izzeddin A. Bakri 4  \n1 Medical Research Club, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine, 2 Department of Urology, Al-Makassed Islamic Charitable Hospital, Jerusalem, Palestine, 3 Department of Oncology, Beit Jala Hospital, Bethlehem, Palestine, 4 Department of Pathology, Al-Makassed Islamic Charitable Hospital, Jerusalem, Palestine  \nIntroduction: Multiple primary malignant neoplasms (MPMNs) are cancers presenting distinct pathological types that originate from different tissues or organs. They are categorized as either synchronous or metachronous . Nowadays, the incidence of MPMN is increasing.  \nPatients and methods: We present a case of a 71-year-old male patient with a medical history of hepatitis B and a family history of breast and endometrial cancers. The patient reported a nasal tip skin lesion with recurrent bleeding, and the history disclosed lower urinary tract symptoms. Further investigations revealed the coexistence of four primary cancers: basosquamous carcinoma of the nasal lesion, prostatic adenocarcinoma, hepatocellular carcinoma, and clear cell renal cell carcinoma.  \nResults: A multidisciplinary team cooperated to decide the proper diagnostic and therapeutic modules.  \nConclusion: To the best of our knowledge, the synchronization of these four primary cancers has never been reported in the literature. Even so, multiple primary malignant neoplasms, in general, are no longer a rare entity and need proper explanations, a precise representation of definition and incidence, further work-up approaches, and treatment guidelines as well.  \nKEYWORDS  \nmultiple primary malignant neoplasms, multidisciplinary team, basosquamous carcinoma, prostatic adenocarcinoma, hepatocellular carcinoma, clear renal cell carcinoma  \n01 [frontiersin.org](frontiersin.org)  \n1 Introduction  \nMultiple primary malignant neoplasms (MPMNs) are defined as two or more primary malignant tumors, each presenting a distinct pathological type that originates from a different tissue or organ (1, 2) . MPMNs are categorized as either synchronous or metachronous by the Surveillance Epidemiology and End Results (SEER) Program, the International Association of Cancer Registries (IACR), and the International Agency for Research on Cancer (IARC) based on the period between each cancer diagnosis (3) .  \nMPMNs were first described by Billroth in 1889 (4) and extensively studied by Warren and Gates in 1932 (1) . Since then, MPMNs have been widely explored, and many cases have","cbCaigUdK5zyKjqV","https://ap.wps.com/l/cbCaigUdK5zyKjqV","pdf",3786746,"English","# Introduction\n## Definition and classification of MPMNs\n## Risk factors and diagnostic approach\n# Case presentation\n## Patient history and clinical presentation\n# Patients and methods\n# Results\n# Conclusion","[{\"question\":\"What are multiple primary malignant neoplasms (MPMNs) and how are they classified?\",\"answer\":\"MPMNs are two or more primary malignant tumors, each showing a distinct pathological type from different tissues or organs. They are categorized as synchronous or metachronous based on the interval between diagnoses.\"},{\"question\":\"What four primary cancers were identified in the presented patient?\",\"answer\":\"The case includes basosquamous carcinoma of the nasal tip, prostatic adenocarcinoma, hepatocellular carcinoma, and clear cell renal cell carcinoma.\"},{\"question\":\"Why is the case considered unusual in the literature?\",\"answer\":\"The authors state that the synchronization of these four primary cancers has never been reported in the literature, while MPMNs in general are increasingly recognized and require proper explanation and guidance.\"}]","An unusual occurrence of multiple primary malignant neoplasms: a case report and narrative review | PDF",1789991328]