Authors: E S Keerthika Sri, S Sowmya, K Shanmugasamy, K Anandrajvaithy
Introduction: Patients with multiple primary malignancies (MPMs) are progressively increasing and MPM includes metachronous and synchronous tumours. Synchronous tumour is defined as two or more neoplasms identified simultaneously in the same patient or a second tumour identified up to six months after the initial diagnosis. In India, the incidence of synchronous colorectal adenocarcinoma varies and according to the literature, ranges from 2 to 5%. Case presentation: In the present case scenario a 68 year old male presented with left pre auricular swelling for 2 months duration along with right axillary swelling f or the past one month with history of loss of appetite and significant weight loss. Cytology of parotid swelling showed features of mucoepidermoid ca rcinoma (MEC) of salivary gland and right axillary swelling revealed metastatic deposits from adenocarcinoma. In addition, the axillary node excision biopsy revealed metastatic deposits from mucoepidermoid carcinoma. Pan endoscopy guided biopsy showed features of adenocarcinoma of duodenum. Conclusion: Strong clinical acumen and suspicion are required to identify cases of MPM and to differentiate them from metastatic disease. While synchronous tumour is known to occur among colorectal region and below diaphragm, MPM involving head and neck region [parotid] and sub diaphragmatic region (duodenum) makes this case report unique. Keywords: Duodenal carcinoma, Mucoepidermoid carcinoma, Synchronous tumour.
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