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[Synchronous multiple primary malignant tumors accompanied by glioblastoma. Case report].

A case of synchronous multiple primary malignant tumors accompanied by glioblastoma is reported. The patient, a 27-year-old woman, was admitted with nausea, vomiting, and a slight consciousness disturbance. Five months before, she had noticed a lump in both breasts, and 1 month later, an abnormal shadow was noted on chest X-ray. Computed tomography scan showed a cystic lesion with ring-like enhancement in the left frontal lobe. Chest X-ray and the tomogram showed a tumor shadow in the right upper lung field. The brain tumor was totally removed. Histologically, it was glioblastoma (first primary focus). One month following brain surgery, a bilateral mastectomy with lymph-node dissection was performed. Histopathological examination revealed ductal carcinoma without metastasis to lymph-node, and they were diagnosed as bilateral primary breast carcinomas (second and third primary foci). Lung tumors gradually progressed in spite of chemotherapy, and she expired due to respiratory insufficiency. Histopathological examination of the autopsied lungs revealed primary papillary adenocarcinoma of apical portion of the upper lobe of right lung with numerous small hematogenously disseminated metastatic tumor nodules in entire lobes of both lungs (fourth primary focus). Moreover, an occult sclerosing carcinoma of papillary type was found in the thyroid (fifth primary focus). There have been no previous reports on five synchronous primary malignant tumors in which one of the primary sites was within the brain.