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Multiple primary malignancies are no longer rare in clinical practice. The incidence of multiple primary malignant neoplasms is the consequence of progress in oncological treatment and diagnostic methods, as well as the higher overall survival rate and life expectancy rate. We present a case of a patient who synchronously developed four malignancies: cervical cancer, breast cancer, chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) and an olfactory groove meningioma. This case proves that the diagnosis of the cervical cancer does not exclude the occurrence of other malignancies. It also emphasizes the fact that every case of uterine cervical cancer with atypical clinical presentation should be thoroughly analyzed to avoid diagnostic mistakes, which in turn may worsen the prognosis.

Intimal sarcoma of the heart and pulmonary artery is a very rare, malignant, primary tumour. The prognosis in patients with primary sarcoma of the pulmonary artery, including intimal sarcoma, is poor. We present the case and 3-years follow-up of 36-year-old woman who was successfully treated with surgical, partial resection of the tumour followed by radiotherapy.

The authors report two cases of adult patients with craniopharyngioma recurrence after surgery. In both these patients radiotherapy resulted in a complete regression of the neoplasms, confirmed both by clinical examination and MR imaging. In both cases modern radiotherapy techniques were used so as to spare healthy tissues surrounding the tumor. Case 1. A 56-year-old man was admitted with an extensive (3.5 x 4.0 x 4.0 cm) recurrent craniopharyngioma 3 years after the initial surgery and 3 months after a surgery for relapse. Conformal 3-D planned fractionated radiotherapy to the total dose of 54 Gy in 30 fractions was delivered encompassing the tumor with 5 mm margins. Four months after radiotherapy MR imaging demonstrated a complete regression of the neoplasm and the patient recovered totally from his endocrine deficiency and neurological symptoms. Case 2. A 29-year-old man was irradiated 10 months after the initial surgery when a relapse of craniopharyngioma was found in MR imaging. The largest diameter of this recurrent tumor was 18 mm. The patient was subjected to fractionated stereotactic radiotherapy to the total dose of 54 Gy in 27 fractions. Two months after the treatment his complete recovery was confirmed by MRI. Benefits resulting from the use of more recent radiotherapy techniques in the management of craniopharyngioma are discussed.

Results of treatment of 119 patients with locally advanced breast cancer in the III-rd and IV-th stage of clinical advancement previously treated with conventional radiotherapy (250 kV, HVL-3.0 mm Cu) have been retrospectively analysed. In 39 patients radical mastectomy has been performed following irradiation. In the total group 36.6% of complete 5 year survivals and 18.5% of symptomless survivals (median of survivals 28.2 months) has been obtained. Operated patients presented significantly better prognosis (56.0% s. 26.9% of 5 year of total survivals). Main cause of treatment failures has been the appearance of remote metastases (76.5%). Unfavourable prognostic factors appeared to be major enlargement of lymphatic nodes (over 3.0 cm), their immobilization and absence of significant regression of primary tumor following irradiation. Size of the primary tumor and age of patients did not significantly influence the result of treatment.