PRIMARY carcinoma multiplex is a term used to describe the presence of two or more primary malignant neoplasms in the same or in separate organs of a patient. The occurrence of three or more primary malignant lesions in three or more organs is a rare finding. Even more rare is the occurrence of four primary malignant neoplasms in four separate organs.
Major,1 in 1918, and Owen,2 in 1921, were the first authors to review the literature on the subject of multiple carcinomas thoroughly and to list the causes of multiple malignant lesions that had been reported. Warren and Gates,3 after a critical survey of the literature in 1932, collected reports on 1,259 patients whom they accepted as having true primary carcinoma multiplex. These authors proposed the following widely accepted criteria for the diagnosis of primary carcinoma multiplex. "Each of the tumors must present a definite picture
GRACEY DR, SPIEKERMAN RE, RALSTON DE, ReMINE WH, DOCKERTY MB. Multiple Primary Carcinomas: Report of a Patient With Four Primary Malignant Tumors. Arch Intern Med. 1965;115(2):217–222. doi:10.1001/archinte.1965.03860140097022
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