Multiple Primary Carcinomas

Abstract

Two or more primary carcinomas rarely occur in the same person. I have recently reviewed the literature on the subject and place on record forty-nine additional cases. This paper is divided into three sections: (1) a partial record of my survey of the literature; (2) an analysis of eighteen cases of multiple primary carcinomas occurring in 3000 consecutive post-mortem examinations at The Mayo Clinic; (3) an analysis of thirty-one cases in which a clinical diagnosis was made at The Mayo Clinic. Review of the Literature Billroth (2) reported a case in 1869 of a patient with carcinoma of the stomach and also one of the external ear. He emphasized the importance of the criteria used as a basis for diagnosis, and established three postulates which he felt were necessary for the diagnosis of multiple primary tumors: (1) each tumor must have an independent histologic appearance; (2) the tumors must arise in different situations; (3) each tumor must produce its own metastasis. Mercanton (9) added a fourth requirement, that there be no recurrence of tumors after their removal.