Primary multiple neoplasms (polyneoplasia) are among the interesting and insufficiently studied fields of oncology. The term polyneoplasia is usually used for two or more malignant neoplasms in a single patient, which occur synchronously or metachronously. Over the last decade, an increase of primary multiple tumors prevalence has been observed. In 2015 39 195 new cases of primary multiple tumors were registered in Russia and comprised 6.7% of all incident malignant neoplasms. Primary multiple metachronous and primary multiple synchronous tumors with two neoplasms development are observed most often, with three more rarely, and with four or more very rarely. In average, 0.1% of a total number of oncologic patients have at least three malignant neoplasms. Primary multiple tumors of gastrointestinal tract are observed most often. The current article presents a clinical case of four synchronous tumors in a single patient localized in major duodenal papilla, sigmoid, transverse colon and lung.
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