Multiple Primary Malignancies

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Abstract
MULTIPLE primary malignancies were considered rare and unusual when first described by Billroth1 in 1879. As subsequent authors have shown,2,3 they are relatively common. The surgeon should be aware of their frequent sites and behavior. In order to delineate these important factors in relation to multiple malignancies, patients with multiple malignancies seen at the University Hospital from 1949 through 1964 were reviewed. A total of 220 patients were found who fulfilled the criteria for multiple primary malignancies as established by Warren and Gates4 in 1932. These criteria are: each tumor must be clearly malignant; each must be separate; and the possibility that one is a metastasis of the other must be excluded. No cases were included without histologic proof of malignancy. In all doubtful cases the slides were reviewed and correlated with the gross findings and clinical course. Of the 220 patients, 112 were men and 108