Abstract
Aim: Aim of this study is to report a rare combination of synchronous double primary malignancies and to review the literature
with reference to so far reported cases.
Case Report: A 48 years old male patient presented to us with lower abdominal pain and burning micturition of one month
duration. Based on clinical presentation and investigation reports he was diagnosed as a case of synchronous double primary
malignancies of ascending colon and urinary bladder. After complete workup for both the malignancies, he underwent Trans
Urethral Resection of Bladder Tumour (TURBT) and radical right hemicolectomy.
Discussion: The term Multiple Primary Malignant Neoplasms (MPMNs), was first used by Billroth in 1889. They can be synchronous
or metachronous. Extensive literature search shows only four cases of synchronous double primaries involving urinary
bladder and colon. We are reporting a rare combination of synchronous double primary malignancies of urinary bladder and
ascending colon. This is the fifth case report of synchronous double primaries involving bladder and colon & third case report
involving bladder and ascending colon to the best of our knowledge.
Conclusion: MPMNs are still elusive for want of proper guidelines regarding correct terminology and classification encompassing
varying presentations of chronological, aetiological, clinical and histopathological combinations. Our case adds up to
literature for further research. The possibility of occurrence of synchronous multiple primary malignancies should be considered
during workup for any malignant condition to institute early intervention to achieve good outcome.

Key words: Colonic adenocarcinoma, Synchronous primaries, Urothelial carcinoma