# Dual Primary Gastric and Rectal Adenocarcinoma: A Case Report with Management Insights: Dual Primary Gastric and Rectal Adenocarcinoma

## TL;DR

A 62-year-old man had both rectal and gastric cancers successfully treated with tailored therapies, showing the importance of early detection and personalized care.

## Contribution

This case highlights successful multidisciplinary management of dual primary cancers with tailored neoadjuvant therapy in a resource-limited setting.

## Key findings

- Complete pathological response achieved in rectal cancer after FOLFOX and chemoradiotherapy followed by surgery.
- Gastric cancer also showed complete response after similar treatment and gastrectomy.
- Personalized treatment strategies can be effective even in resource-constrained environments.

## Abstract

Dual primary malignancies, including colorectal (CRC) and gastric cancers
(GC), are complicated cases due to the complexity of managing patients.

This case report presents a 62-year-old male patient with rectal and gastric
adenocarcinomas. Initially, rectal adenocarcinoma after a complaint of
hematochezia was diagnosed by prognostic modalities. The patient received
total neoadjuvant therapy with FOLFOX chemotherapy and chemoradiotherapy.
After surgery, a complete pathological response was obtained. A few months
later, gastric adenocarcinoma with persistent heartburn was detected through
esophagogastroduodenoscopy (EGD). total neoadjuvant therapy with FOLFOX
chemotherapy and chemoradiotherapy followed by total gastrectomy were
prescribed. After gastrectomy, a complete pathological response was
obtained.

This case of synchronous CRC and GC, diagnosed 5 months apart, underscores
the pivotal role of early detection and multidisciplinary management in
achieving favorable outcomes. Complete pathologic responses in both
malignancies following tailored TNT with FOLFOX and FLOT regimens, combined
with surgical interventions, highlight the efficacy of personalized
treatment strategies, even in resource-constrained settings. Continued
research is essential to optimize diagnostic protocols, refine therapeutic
approaches, and improve access to genetic testing for synchronous and
metachronous malignancies, promoting equitable cancer care globally.