A clinical report and analysis of metachronous multiple primary cancers occurred in four sites

Purpose This case report aims to describe a rare occurrence of quadruple primary malignancies—bilateral primary breast cancer, ovarian cancer, and pleomorphic malignant fibrous histiocytoma/undifferentiated high-grade pleomorphic sarcoma—and to explore its potential association with hereditary tumor syndromes. Methods We conducted a detailed clinical and histopathological analysis of the case. Repeated imaging and pathological examinations were performed to confirm the diagnosis of each primary malignancy. Results The patient was diagnosed with four distinct primary tumors, and pathological evaluation confirmed each malignancy. Conclusion This case underscores the importance of comprehensive pathological and genetic evaluation in patients with multiple primary malignancies. It highlights the increasing incidence of such tumors among long-term cancer survivors and offers valuable clinical perspectives for diagnosis and management in the context of hereditary cancer syndromes.