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Updated: Aug 15, 2026

Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
Published on: February 6, 2019
Four primary tumors of lung, bladder, prostate, and breast in a male patient
Zaher K Otrock1, Rami A R Mahfouz, Ziad M Salem
1Department of Internal Medicine, Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Abstract:
We present a very rare case of quadruple cancers in a 65-year-old male patient. It is a case of both synchronous and metachronous primary malignant neoplasms occurring in four different organs. Immunohistochemical stains showed tumor cell nuclei to be negative for p53 over-expression. To our knowledge, this is the first documented case with this combination of primary tumors. The tumors included an adenosquamous cell carcinoma of the lung, transitional cell carcinoma of the urinary bladder, and adenocarcinomas of the prostate and the breast. We also review the medical literature for the possible causes of multiple primary malignant neoplasms.
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