[Asynchronous quadruplicate malignancies: cancer of the stomach, breast and uterus and acute leukemia].

A 71-year-old female was admitted to the Fukui Red Cross Hospital because of abnormal genital bleeding in Feb., 1987. She underwent gastrectomy for early gastric cancer (IIc) 5 years earlier, mastectomy for early breast cancer (stage I) 3 years earlier and radiation therapy (60Co 350rad x 25 days) and chemotherapy (5FU, 200 mg/day, orally) for uterine cancer (stage IIb) 2.5 years earlier. These 3 cancers had quite different histological features one from the other. Laboratory investigation revealed leukocytosis (216, 100/microliters) with 90% blasts. The bone marrow was hyperplastic with 87% blasts. Although 90% of blasts had myeloperoxidase activity, surface marker analysis of the blasts revealed T-cell (CD2, CD3) phenotypes suggesting that the disease was so-called hybrid acute leukemia. She died of intracranial hemorrhage on the 2nd hospital day. An autopsy showed generalized leukemic infiltration and residual uterine cancer without metastasis to other sites. In our country, quadruplicate malignancies including hematological malignancy have been rarely described. The possible pathogenesis of multiple cancers has been discussed.