title: [Multiple primary neoplasms - coincidence or tumor syndrom?].
abstract: BACKGROUND
  Multiple primary neoplasms occur either by hazard or in the context of hereditary cancer syndromes, after chronic toxic exposition, in immunodeficiency or as secondary malignancies after radio- and/or chemotherapy.
  
  
  METHODS
  We present the history of an actually asymptomatic female patient with four different malignancies within 30 years: malignant melanoma (1976), liposarcoma (1983), carcinoma of the appendix (2006) and lymphoma (2006).
  
  
  CONCLUSIONS
  There is not only a remarkable variety of malignant tumors but also an extraordinary long survival without recurrence of the generalised malignomas of the skin and soft tissue (malignant melanoma and liposarcoma). It is difficult to explain the entire restitution with the implemented treatments (several tumor resections, chemotherapy with Ifosfamide). More than 20 years after chemotherapy, the lymphoma can be classified as a secondary malignoma. We discuss the pathogenesis of multiple malignomas in further details.
authors.affiliation: Departement Chirurgie, Viszeralchirurgie, Kantonsspital Graubünden, Chur.
authors.forename: C
authors.initials: C
authors.lastname: Schrofer
authors.forename: P
authors.initials: P
authors.lastname: Villiger
authors.forename: R
authors.initials: R
authors.lastname: Cathomas
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000368:Aged; D001063:Appendiceal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007078:Ileal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008080:Liposarcoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008198:Lymph Nodes / Q000473:pathology; D008224:Lymphoma, Follicular / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008545:Melanoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D013577:Syndrome