{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T22:34:04Z","timestamp":1790289244508,"version":"4.1.0"},"reference-count":16,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,4,28]]},"abstract":"<jats:p>Triple synchronous primary malignant neoplasms are rare. The exact aetiology is unknown; however, risk factors include older age, family history, genetic aberrations, prolonged exposure to carcinogens and smoking. We describe a previously healthy 48-year-old woman who presented with abdominal pain and a palpable abdominal mass. Imaging revealed a complex cystic, solid pelvic mass and another mass in the right upper quadrant. She received an extensive abdominal surgery including exploratory laparotomy, pelvic mass resection, total abdominal hysterectomy, bilateral salpingo-oophorectomy, bilateral pelvic lymphadenectomy, omentectomy and right adrenalectomy. During surgery, a mass in the distal sigmoid colon was noted and subsequent sigmoidectomy was performed. The surgical specimen revealed three different primary tumours with three different histologies, a granulosa cell tumour of the ovary, adrenocortical carcinoma and adenocarcinoma of the colon. She received six cycles of adjuvant chemotherapy for colon cancer with 5-fluorourocil, leucovorin and oxaliplatin and is currently living with no recurrence.<\/jats:p>","DOI":"10.1136\/bcr-2017-219237","type":"journal-article","created":{"date-parts":[[2017,6,5]],"date-time":"2017-06-05T09:25:11Z","timestamp":1496654711000},"page":"bcr-2017-219237","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Triple synchronous primary malignancies: a rare occurrence"],"prefix":"10.1136","volume":"2017","author":[{"given":"Heather","family":"Katz","sequence":"first","affiliation":[{"name":"Department of Oncology, Joan C Edwards School of Medicine at Marshall University, Huntington, West Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassaan","family":"Jafri","sequence":"additional","affiliation":[{"name":"Internal Medicine, Joan C Edwards School of Medicine at Marshall University, Huntington, West 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