Multiple primary cancers with gastrointestinal malignant tumors as the first manifestation - Three case reports and review of literature

Sep 23, 2026

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Malignant gastrointestinal (GI) tumor incidence is rising alongside improved survival, increasing the number of patients with multiple primary cancers (MPC). The rarity of MPC and lack of sensitive, specific diagnostic markers often cause missed or incorrect diagnoses, making clinician vigilance and accurate detection essential. Patients with GI malignancies carry a higher relative risk for additional primary malignancies than other systemic tumors. Careful monitoring and follow-up are critical, particularly for high-risk groups such as older adults, men, alcohol and tobacco users, those with tumor family history, and patients who previously received radiotherapy.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Case report

Abstract (Background, Case summary, Conclusion)

Core tip

Introduction

| W | J | G | World Journal of
Gastroenterology | | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Gastroenterol 2025 February 28; 31(8): 100146 DOI: 10.3748/wjg.v31.i8.100146 ISSN 1007-9327 (print) ISSN 2219-2840 (online) CASE REPORT Multiple primary cancers with gastrointestinal malignant tumors asthe first manifestation: Three case reports and review of literature Xin-Ran Bi, Shuang-Yan Zhao, Yu-Qi Ma, Xiao-Yu Duan, Ting-Ting Hu, Lian-Zhu Bi, Hong-Yi Cai Specialty type: Gastroenterology and hepatology Provenance and peer review: Unsolicited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s classification Scientific Quality: Grade B, Grade B, Grade B Novelty: Grade A, Grade B, Grade B Creativity or Innovation: Grade B, Grade B, Grade B Scientific Significance: Grade B, Grade B, Grade B P-Reviewer: Leng KM; PriegoParra BA Received: August 8, 2024 Revised: December 3, 2024 Accepted: January 13, 2025 Published online: February 28, 2025 Processing time: 167 Days and 13.6 Hours Xin-Ran Bi, Shuang-Yan Zhao, Yu-Qi Ma, The First Clinical Medical College of Gansu University of Traditional Chinese Medicine, Lanzhou 730000, Gansu Province, China Xin-Ran Bi, Shuang-Yan Zhao, Xiao-Yu Duan, Ting-Ting Hu, Hong-Yi Cai, Department of Radiotherapy Center, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China Yu-Qi Ma, Department of Gastrointestinal Surgery, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China Lian-Zhu Bi, Department of Neurology, Hospital of Fengnan District, Tangshan 063300, Hebei Province, China Co-first authors: Xin-Ran Bi and Shuang-Yan Zhao. Corresponding author: Hong-Yi Cai, Doctor, Chief Physician, Professor, Department of Radiotherapy Center, Gansu Provincial Hospital, No. 204 East Gang West Road, Lanzhou 730000, Gansu Province, [China.](China. gschy333@163.com)[ gschy333@163.com](China. gschy333@163.com) Abstract BACKGROUND The incidence of malignant gastrointestinal (GI) tumors is increasing, and advancements in medical care have significantly improved patient survival rates. As a result, the number of cases involving multiple primary cancers (MPC) has also increased. The rarity of MPC and the absence of sensitive and specific diagnostic markers often lead to missed or incorrect diagnoses. It is, therefore, of vital importance to improve the vigilance of clinicians and the accurate diagnosis of this disease. Patients with GI malignancies face a higher relative risk of developing additional primary malignant tumors compared to those with other systemic tumors. Vigilant monitoring and follow-up are crucial, especially for high-risk groups, which include older adults, men, those with addictions to alcohol and tobacco, those with a family history of tumors, and those who have undergone radiotherapy. CASE SUMMARY In this article, we report three cases of MPC, each involving malignant tumors of the GI tract as the initial primary carcinoma, offering insights that may aid ineffectively managing similar cases. CONCLUSION WJG [https://www.wjgnet.com](https://www.wjgnet.com) 1 February 28, 2025 Volume 31 Issue 8 Bi XR et al. Three cases of MPCs Patients with GI malignancies face a higher MPC risk. Developing screening and follow-up protocols may enhance detection and treatment outcomes. Key Words: Multiple primary cancer; Gastrointestinal tract; Synchronous; Metachronous; Case report ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved. Core Tip: Multiple primary cancer (MPC) refers to the presence of two or more distinct primary malignant tumors that arise in either the same organ or multiple separate organs and tissues within a single patient. This article offers a detailing three cases of gastrointestinal malignancies with MPCs. It features a thorough presentation of endoscopic, tomog

FAQs

What is the main focus of this case report article?

The article presents three case reports where gastrointestinal malignant tumors are the first manifestation of multiple primary cancers, and it includes a review of the literature.

Why are multiple primary cancers (MPC) often difficult to diagnose?

MPC is rare and there are limited sensitive and specific diagnostic markers, which can lead to missed or incorrect diagnoses.

Which patients are highlighted as being at higher risk for additional primary malignancies?

High-risk groups include older adults, men, people with addictions to alcohol and tobacco, those with a family history of tumors, and patients who have undergone radiotherapy.

Sep 23, 2026

Uploaded by Ezra