Multiple Primary Malignant Neoplasms

87 3. All polyps should be promptly treated by resection or fulguration as soon as possible after their discovery. 4. The physician must assume the responsibility for impressing the patient with the necessity for frequent and regular follow-up examinations. These examinations must be done at no longer than 1-year intervals for at least 5 years after treatment of the initial lesion and preferably at yearly intervals thereafter. 5. A minimal follow-up examination must include a proctoscopic examination as well as a careful roentgenologic examination of the colon. Summary The literature concerning multiple colonic carcinomas has been reviewed. Data have been presented on 261 cases in which multiple carcinomas of the colon were seen at the Mayo Clinic from January 1, 1944, through December 31, 1953. 0 This represents a known rate of occurrence of 4.3 /0. A marked tendency to multiplicity has been observed in carcinoma of the colon associated with multiple polyposis or with chronic ulcerative colitis. Some evidence has been obtained of hereditary factors in predisposition to malignant disease of the colon. When the diagnosis of a malignant lesion of the colon or rectum has been made, the entire large bowel must be considered a potential source of malignant disease. An integral part of the management of carcinoma of the large bowel must be constant vigilance to ensure early diagnosis and adequate treatment of both simul taneous and interval lesions. References ALBRECHT, P.: Ober die Multiplizitat primarer maligner Geschwiilste. Oncologia (Basel) 5, 12 (1952).

Inhalt
A. Introduction and Presentation of Data.- 1. Criteria for Diagnosis.- 2. Classification.- 3. Selection of Cases for Our Study.- 4. Observations.- 5. Rate of Occurrence.- 6. Report of Cases.- Summary.- References.- B. Multiple Primary Malignant Neoplasms of Different Tissues or Organs.- 1. Introductory Comments.- 2. Occurrence of Multiple Cancers within the Same or Related Organ Systems.- 3. Second Primary Cancers Induced by Treatment of an Initial Malignant Neoplasm.- 4. Hereditary Influences in Patients with Multiple Primary Malignant Neoplasms.- 5. Blood Groups and Multiple Primary Malignant Neoplasms.- 6. Leukemia or Lymphoma and Coexistent Primary Malignant Neoplasms.- 7. Carcinoid Tumors of the Small Intestine and Second Primary Cancers.- 8. The Coexistence of Primary Lung Cancer and Other Primary Malignant Neoplasms.- C. Multiple Primary Malignant Neoplasms of Multicentric Origin.- 1. Introductory Comments.- 2. Multicentric Epitheliomas of the Skin.- 3. Multicentric Carcinomas of the Oral Cavity.- 4. Multicentric Epitheliomas of the Lips.- 5. Multicentric Epitheliomas Involving the Larynx, Pharynx, and Esophagus.- 6. Multicentric Adenocarcinomas of the Stomach.- 7. Multicentric Carcinoid Tumors.- 8. Multicentric Adenocarcinomas of the Colon and Rectum.- References.- 9. Multicentric Epitheliomas of the Urinary Tract.- 10. Multicentric Carcinomas of the Cervix, Vagina, Vulva, and Anus.- 11. Bilateral Carcinomas of the Breast.- 12. Bilateral Testicular Cancers.- 13. Bilateral Ovarian Carcinomas.- 14. Multicentric Bronchial Carcinomas.- 15. Multicentric Carcinomas of Parenchymatous Organs.- 16. Multicentric Gliomas of the Central Nervous System.- 17. Multicentric Malignant Neoplasms of the Reticuloendothelial System.- 18. The Case for Multicentricity of Origin of Malignant Neoplasms.