Clinicopathological Characteristics of Multiple Primary Malignancies Involving Female Genital Tract at a Tertiary Cancer Institute of Northeast India

Sep 21, 2026

Multiple Primary Malignant Neoplasms (MPMNs) denote two or more unrelated primary cancers arising in one patient, classified as synchronous or metachronous by timing after the first malignancy. This hospital-based retrospective study evaluated clinicopathological factors in patients attending gynecological oncology with at least one female genital tract malignancy, excluding ambiguous primary status and incomplete treatment of the first cancer. Among 57 patients (including one triple primary), 59.18% were metachronous; median time to the second primary was 60 months. Cervix led as first diagnosis; endometrium and ovary were frequent second-site and synchronous involvement, with predominantly low-grade endometrioid histology.

LanguageEnglish

CategoryResearch & Report

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Abstract

Introduction

The term multiple primary malignant neoplasms (MPMNs)

Materials and Methods

Original Article Clinicopathological Characteristics of Multiple Primary Malignancies Involving Female Genital Tract at a Tertiary Cancer Institute of Northeast India Eshwarya Jessy Kaur, Debabrata Barmon1, Upasana Baruah1, Dimpy Begum1 Department of Obstetricsand Gynaecology, Command Hospital, Lucknow, Uttar Pradesh, 1Department of Gynaecological Oncology, Dr. B Borooah Cancer Institute, Tata Memorial Hospital, Guwahati, Assam, India Submitted: 25‑Mar‑2024 Revised: 26‑Apr‑2024 Accepted: 31‑May‑2024 Published: 17‑Oct‑2024 Abstract Background: The term “Multiple Primary Malignant Neoplasms (MPMNs)”refers to two or more unrelated primary malignant neoplasms that originate from single or different organs and occur in one patient. MPMNs have been divided into synchronous and metachronous based on time duration after first malignancy. Materials and Methods: This was a hospital‑based retrospective study conducted at a tertiary cancer institute in Northeast India. Clinicopathological factors of patients with multiple primary malignancies with at least one female genital tract malignancy attending the gynecological oncology outpatient department were observed. Those with ambiguous status of primary malignancy and incomplete treatment of first primary malignancy were excluded from the study. Results: A total of 57 patients with MPMN, including one case of triple primary malignancy, were included in the study. 59.18% of cases had metachronous, and 40.81% had synchronous malignancies. The median time to the development of second primary malignancy was 60 months. Among the first diagnosed malignancies, cervix was the most common site (26.5%), followed by endometrium (20.4%) and ovary (14.28%), whereas ovarian malignancy was more commonly diagnosed second malignancy (38.77%), followed by endometrium (14.28%) and cervix (10.2%) . In an analysis of synchronous malignancies, the most common genital tract involvement was seen with endometrium and ovary, with a predominance of low‑grade endometrioid histology in 75% of cases. Conclusions: As the cancer survivor population continues to increase in future, these patients must be comprehensively evaluated on follow‑up, and a cognizance of prior treatment taken should be kept. In addition, it is vital that the clinicians keep a lookout for high‑risk population in which genetic testing may be beneficial. Keywords: Hereditary breast and ovarian cancer, metachronous malignancy, multiple primary malignancies, synchronous malignancy Introduction The term multiple primary malignant neoplasms (MPMNs) refers to two or more unrelated primary malignant neoplasms that originate from single or different organs and occur in one patient. The credit for description of the term multiple primary malignant tumor goes to Billroth, who described it for the first time in 1869, whereas in 1932, Warren and Gates first published and described patients with MPMN. A varied pathoetiology for the development of these tumors has | Access this article online | | | --- | --- | | Quick Response Code:
| Website: [https://journals.lww.com/jomh](https://journals.lww.com/jomh) | | | DOI: 10.4103/jmh.jmh_55_24 | been postulated. These include the field cancerization effect, an underlying genetic imbalance common to both the tumors, and the effects of therapeutic interventions such as radiation, topoisomerase inhibitors, and alkylating agents. Other implicated causes are | Address for correspondence: Dr. Eshwarya Jessy Kaur, Department of Obstetrics and Gynaecology, Command Hospital, Lucknow ‑ 226 002, Uttar Pradesh, India.
E‑mail: [eshwaryareen12@gmail.com](eshwaryareen12@gmail.com) | | --- | | This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution‑NonCommercial‑ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non‑commercially, as long as appropriate credit is given and the new creations are license

FAQs

What does MPMN mean, and how is it classified in this study?

MPMNs refer to two or more unrelated primary malignant neoplasms occurring in one patient. They are divided into synchronous and metachronous categories based on the time interval after the first malignancy.

How many patients were included, and what were the key proportions of metachronous vs synchronous cases?

The study included 57 patients with MPMN, including one case of triple primary malignancy. Metachronous malignancies accounted for 59.18% of cases, while synchronous malignancies accounted for 40.81%.

What was the median time to development of the second primary malignancy?

The median time to the development of the second primary malignancy was 60 months.

Sep 21, 2026

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