Multiple synchronous colorectal carcinomas

Abstract The authors studied 118 patients with colon cancer (65 males and 53 female) admitted and operated at the Surgical Department of the Casalpusterlengo Hospital (Milan, Italy); over a period of 5 years (1986-1990). All patients were submitted to a pre-op. work-up with Barium enema, colonoscopy, abdominal ultrasound exam, and PAP-test and mammogram for females patients. We found 7 cases (5.9%) of multiple synchronous colon cancer (in 4 patients 2 cancers and in 3 patients 3 cancers). We also found extracolonic malignancy in the same patients (1 synchronous and 2 metachronous). New criteria are proposed to distinguish multiple colon cancers from multifocal colon cancers. It may be concluded that every patient with colo-rectal cancer requires a complete pre-op. examination of the colon and some tests to rule out other extracolonic malignancy.