Synchronous multiple primary colorectal cancer with discordant RAS status between primary lesions: a case report in an elderly patient - Takeaways - MDSpire

Concurrent Multiple Primary Colorectal Cancers with Divergent RAS Status in Primary Tumors: A Case Study of an Elderly Individual

By
Junting Guan
Jiyuan Chen
Shengqi Pan
Qi Li
Guiyu Wang
Qingchao Tang
August 17, 2026

Frontiers In Surgery

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1

Synchronous multiple primary colorectal cancer (SMPCRC) is rare, comprising 1% to 8% of colorectal cancer cases, with multiple lesions occurring within six months.
2

A 77-year-old male was diagnosed with four distinct colorectal lesions, including adenocarcinomas and a rectal adenoma with intramucosal carcinoma.
3

Molecular testing revealed discordant RAS mutation statuses; the rectal lesion had mutations while the sigmoid colon lesion was RAS/RAF/PIK3CA wild-type.
4

The patient underwent a multimodal treatment approach, including synchronous surgery, endoscopic dissection, and personalized chemotherapy adjustments.
5

Eighteen months post-treatment, the patient showed no signs of recurrence and maintained a satisfactory general condition.

Original Source(s)

Frontiers In Surgery

Synchronous multiple primary colorectal cancer with discordant RAS status between primary lesions: a case report in an elderly patient

by Junting Guan, Jiyuan Chen, Shengqi Pan, Qi Li, Guiyu Wang, Qingchao Tang
August 17, 2026

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