Batna Journal of Medical Sciences
Volume 13, Numéro 1, Pages 40-43
2026-05-01

Successive Development Of Three Histologically Distinct Primary Malignancies: Synovialosarcoma, Colorectal Adenocarcinoma, And Pulmonary Large Cell Neuroendocrine Carcinoma. A Case Report



Authors : Ammari Abdelaziz . Bensalem Assia . Bensalem Sihem . Ladouali Madjda .

Abstract

The coexistence of multiple primary malignant tumors remains a rare but significant diagnostic and therapeutic challenge in oncology. This complexity is particularly pronounced when the tumors have different histological lineages, such as mesenchymal, epithelial, and neuroendocrine. We present an exceptional case of a 67-year-old male who sequentially developed three distinct primary malignancies over a six-year period: a biphasic synovialosarcoma of the ankle, a colorectal adenocarcinoma, and a primary pulmonary large-cell neuroendocrine carcinoma. The management of each tumor required a distinct multidisciplinary approach, including surgery and adjuvant chemotherapy. This case underscores the critical importance of prolonged, personalized follow-up for patients with a primary malignancy and highlights the necessity of actively searching for underlying hereditary cancer syndromes through genetic testing, which can guide future prevention and therapeutic strategies. This study is a retrospective and observational case report. It is not a clinical trial and does not involve data from an experimental intervention. The data were gathered from patient charts during routine clinical follow-up. Given its retrospective and observational nature, formal approval by an Institutional Review Board (IRB) or research ethics committee was not required, as per national and international institutional guidelines for such reports. All procedures were conducted in accordance with the ethical principles laid out in the 2013 Declaration of Helsinki, guaranteeing the patient's confidentiality, anonymity, and dignity.

Keywords

Multiple primary tumors ; Germline mutations ; Synovialosarcoma ; Colorectal adenocarcinoma ; Large cell neuroendocrine carcinoma

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