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July 24, 1967

Multiple Primary Carcinoma

Author Affiliations

Hartford, Conn

JAMA. 1967;201(4):275. doi:10.1001/jama.1967.03130040071032

To the Editor:—  Patients who are treated for carcinoma in one organ should be observed for the spontaneous emergence of a primary malignant lesion in another site.

Report of a Case:—  A 57-year-old woman had a right radical mastectomy for a grade I adenocarcinoma in January 1954. The 1-cm lesion showed tumor cells mainly within ducts, but there was some invasion. None of ten regional lymph nodes was involved and there was no evidence of metastases or residual tumor (Fig 1).Because of profuse vaginal bleeding in October 1959, she underwent a panhysterectomy. There was a soft, irregular, friable, polypoid mass projecting into the lumen of the endometrial cavity. This grade 2 adenocarcinoma extended deeply into the myometrium but not to the serosal surface (Fig 2). She subsequently received cobalt irradiation to the pelvic region. After recurrent vaginal bleeding, extensive vaginal biopsies in February and July 1960 revealed only fibrous