Triple synchronous cancer of the sigmoid colon and rectum: A case report

Abstract

INTRODUCTION: Synchronous colorectal cancer (SCRC) refers to two or more types of primary colorectal cancers diagnosed in a single patient simultaneously or within six months. Having more than two types of SCRC is extremely rare. PURPOSE: This report describes a case of triple SCRC and includes a systematic literature review to define its prevalence and discuss signs, symptoms, and pathology to provide further understanding of this disease for earlier detection in high-risk individuals. CASE REPORT: A 63-year-old severely anemic male underwent a panendoscopy, esophagogastroduodenoscopy, and colonoscopy to identify the source of bleeding. The procedures revealed three primary carcinomas: 1) adenocarcinoma of the sigmoid colon and rectum, and 2) infiltrating adenocarcinoma of the rectum arising from a tubulovillous adenoma. Laboratory examination revealed a carcinoembryonic antigen level of 30.2 ng/mL. Computed tomography scan revealed no abdominal or pelvic lymphadenopathy and no metastases. DISCUSSION: Characteristic findings of synchronous colorectal carcinoma include: male predominance, average age of 66-years-old, two detected lesions, tumors in the sigmoid colon and rectum, and predisposing factors of inflammatory bowel disease, hereditary non-polyposis colorectal carcinoma, or familial adenomatous polyposis. CONCLUSION: Of the 107,554 colorectal cancer cases included in this literature review, 4,250 cases met the definition of SCRC. To improve earlier detection and overall outcomes, it is imperative to continue researching and learning from each SCRC case.