title: Clinical challenges presented by three simultaneous solid tumors.
abstract: BACKGROUND
  Simultaneous tumors are rare, and their management can be challenging. The simultaneous presentation of cervical carcinoma, renal cell carcinoma, and appendiceal carcinoma has not been previously described.
  
  
  METHODS
  A 57-year-old woman presented with cervical cancer. During her workup, she was diagnosed with mucinous appendiceal carcinoma and clear cell carcinoma of the kidney. One year following surgery, she remains without evidence of disease and with continually improving nutritional status.
  
  
  CONCLUSIONS
  When simultaneous tumors are diagnosed, optimal care requires the creative expertise of a multidisciplinary team. Standard sequential therapies may be problematic in patients undergoing major surgery to treat another primary tumor, and sequential treatment delays rather than combining therapies can jeopardize cure. Treatment planning should utilize a coordinated multidisciplinary approach.
authors.affiliation: Department of Gynecologic Oncology, University of Texas M.D. Anderson Cancer Center, Division of Gynecologic Oncology, Lyndon Baines Johnson General Hospital, Houston, TX 77230-1439, USA.
authors.forename: Y G
authors.initials: YG
authors.lastname: Lin
authors.forename: M
authors.initials: M
authors.lastname: Deavers
authors.forename: F
authors.initials: F
authors.lastname: Sasan
authors.forename: J S
authors.initials: JS
authors.lastname: Zager
authors.forename: L M
authors.initials: LM
authors.lastname: Ramondetta
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D001063:Appendiceal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D011859:Radiography; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy