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Oncol."],"abstract":"<jats:p>The exceedingly rare clinical presentation of synchronous ascending colon carcinoma with duodenal adenocarcinoma demonstrating discordant mismatch repair protein expression patterns forms the cornerstone of this investigation. Through detailed analysis of a unique case featuring co-occurring MSS\/pMMR ascending colon adenocarcinoma and MSI-H\/dMMR duodenal adenocarcinoma, this study demonstrates the successful implementation of multidisciplinary therapeutic protocols achieving 22-month progression-free survival post-radical resection. These clinical findings offer empirical evidence for optimizing clinical management while systematically addressing diagnostic complexities and treatment dilemmas inherent to synchronous dual primary intestinal carcinomas. Particular emphasis is placed on reconciling therapeutic conflicts arising from differential tumor biology and developing precision strategies for molecularly heterogeneous synchronous malignancies.<\/jats:p>","DOI":"10.3389\/fonc.2025.1573580","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T04:11:05Z","timestamp":1748578265000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Simultaneous double primary malignant tumors of MSS\/pMMR ascending colon cancer and MSI-H\/dMMR duodenal cancer with nearly 2 years of recurrence-free survival after MDT-guided comprehensive treatment: a case report"],"prefix":"10.3389","volume":"15","author":[{"given":"Weimin","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quan","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yifan","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuefeng","family":"Cha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaoxian","family":"Xiong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoxia","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pin","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kun","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2018.07.005","article-title":"Cancer incidence and mortality patterns in Europe: Estimates for 40 countries and 25 major cancers in 2018","volume":"103","author":"Ferlay","year":"2018","journal-title":"Eur J Cancer"},{"key":"B2","doi-asserted-by":"publisher","first-page":"394","DOI":"10.3322\/caac.21492","article-title":"Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"68","author":"Bray","year":"2018","journal-title":"CA Cancer J Clin"},{"key":"B3","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1007\/s11894-016-0497-x","article-title":"Small bowel neoplasms and polyps","volume":"18","author":"Pourmand","year":"2016","journal-title":"Curr Gastroenterol Rep"},{"key":"B4","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/j.dld.2013.04.013","article-title":"Small bowel adenocarcinoma: epidemiology, risk factors, diagnosis and treatment","volume":"46","author":"Aparicio","year":"2014","journal-title":"Dig\u00a0Liver Dis"},{"key":"B5","volume-title":"As of January 2024, no relevant case reports have been found through PubMed and ScienceDirect searches (keywords: \u201csynchronous colorectal cancer\u201d, \u201cduodenal adenocarcinoma\u201d, \u201cmismatch repair discordance\u201d)","year":""},{"key":"B6","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.mam.2019.03.001","article-title":"Update on genetic predisposition to colorectal cancer and polyposis","volume":"69","author":"Valle","year":"2019","journal-title":"Mol Aspects Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.60.0213","article-title":"Personalizing colon cancer adjuvant therapy: selecting optimal treatments for individual patients","volume":"33","author":"Dienstmann","year":"2015","journal-title":"J Clin Oncol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2013.677","article-title":"Small bowel adenocarcinoma phenotyping, a clinicobiological prognostic study","volume":"109","author":"Aparicio","year":"2013","journal-title":"Br J Cancer"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2017699","article-title":"KEYNOTE-177 investigators, 2020. 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