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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.",{"@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/multiple-primary-cancers-with-gastrointestinal-malignant-tumors-as-the-first-manifestation-three-case-reports-and-review-of-literature/373075/",{"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/multiple-primary-cancers-with-gastrointestinal-malignant-tumors-as-the-first-manifestation-three-case-reports-and-review-of-literature/373075.png","ImageObject",300,407,{"name":92,"@type":93},"Ezra","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-03","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is the main focus of this case report article?","Question",{"text":112,"@type":113},"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.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Why are multiple primary cancers (MPC) often difficult to diagnose?",{"text":117,"@type":113},"MPC is rare and there are limited sensitive and specific diagnostic markers, which can lead to missed or incorrect diagnoses.",{"name":119,"@type":110,"acceptedAnswer":120},"Which patients are highlighted as being at higher risk for additional primary malignancies?",{"text":121,"@type":113},"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.","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},373075,1790207356,{"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":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},1099514068035,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","| W | J | G | World Journal of\u003Cbr>Gastroenterology |\n| --- | --- | --- | --- |\n\nSubmit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Gastroenterol 2025 February 28; 31(8): 100146  \nDOI: 10.3748/wjg.v31.i8.100146 ISSN 1007-9327 (print) ISSN 2219-2840 (online)  \nCASE REPORT  \nMultiple primary cancers with gastrointestinal malignant tumors asthe first manifestation: Three case reports and review of literature  \nXin-Ran Bi, Shuang-Yan Zhao, Yu-Qi Ma, Xiao-Yu Duan, Ting-Ting Hu, Lian-Zhu Bi, Hong-Yi Cai  \nSpecialty type: Gastroenterology and hepatology  \nProvenance and peer review:  \nUnsolicited article; Externally peer reviewed.  \nPeer-review model: Single blind  \nPeer-review report’s classification Scientific Quality: Grade B, Grade B, Grade B  \nNovelty: Grade A, Grade B, Grade B  \nCreativity or Innovation: Grade B, Grade B, Grade B  \nScientific Significance: Grade B, Grade B, Grade B  \nP-Reviewer: Leng KM; PriegoParra BA  \nReceived: August 8, 2024  \nRevised: December 3, 2024  \nAccepted: January 13, 2025  \nPublished online: February 28, 2025  \nProcessing time: 167 Days and 13.6 Hours  \nXin-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  \nXin-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  \nYu-Qi Ma, Department of Gastrointestinal Surgery, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China  \nLian-Zhu Bi, Department of Neurology, Hospital of Fengnan District, Tangshan 063300, Hebei Province, China  \nCo-first authors: Xin-Ran Bi and Shuang-Yan Zhao.  \nCorresponding 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)  \nAbstract  \nBACKGROUND  \nThe 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.  \nCASE SUMMARY  \nIn 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.  \nCONCLUSION  \n WJG  [https://www.wjgnet.com](https://www.wjgnet.com) 1 February 28, 2025  Volume 31  Issue 8   \nBi XR et al. Three cases of MPCs  \nPatients with GI malignancies face a higher MPC risk. Developing screening and follow-up protocols may enhance detection and treatment outcomes.  \nKey Words: Multiple primary cancer; Gastrointestinal tract; Synchronous; Metachronous; Case report  \n©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.  \nCore 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","cbCaisURAp6mFmhX","https://ap.wps.com/l/cbCaisURAp6mFmhX","pdf",11587651,11,"English","# Case report\n## Abstract (Background, Case summary, Conclusion)\n## Core tip\n## Introduction","[{\"question\":\"What is the main focus of this case report article?\",\"answer\":\"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.\"},{\"question\":\"Why are multiple primary cancers (MPC) often difficult to diagnose?\",\"answer\":\"MPC is rare and there are limited sensitive and specific diagnostic markers, which can lead to missed or incorrect diagnoses.\"},{\"question\":\"Which patients are highlighted as being at higher risk for additional primary malignancies?\",\"answer\":\"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.\"}]","Multiple primary cancers with gastrointestinal malignant tumors as the first manifestation - Three case reports and review of literature | PDF",1790196644,28]