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From 1968-1992 1503 endometrial carcinomas have been evaluated at Bad Trissl Clinic retrospectively. All double and triple carcinomas have been histologically recorded, doubtful cases have been excluded. Double malignomas that occurred within 6 months are termed simultaneous, all others are termed successive ones. Of 1503 endometrial carcinomas 163 (10.8%) were multiple tumors. Of these 100 (6.6%) occur together with breast cancer and 63 (4.2%) with other primary malignomas. 145 (9.6%) are double, 18 (1.2%) are triple malignomas. 10 precancerous cases (0.7%) have been included in the survey. The average latency period from the first to the second malignoma was 4.5 years. Patients with endometrial carcinoma run higher risks of secondary tumors. One out of 10 develops a double malignoma, one out of 100 a triple malignoma. The combination of endometrial and breast cancer occurs in 60% of cases, the combination of genital and breast cancer in nearly 80% of cases. After-care of endometrial carcinoma must also include early detection of potential double and triple malignomas.

In 1987/88 a prospective study was undertaken of 750 patients with postoperative carcinoma of the breast but no evidence as yet of skeletal metastases. A thorough history regarding pain was taken with pre-set questions and an exact clinical examination conducted to reveal any skeletal pain. Subsequently whole-body skeletal scanning was performed, plus additional X-ray films, determination of tumour markers CA-15-3 and CEA, and further tests as indicated. Clinical and imaging results agreed in 649 patients. In 70 patients the clinical suspicion or questionable finding of metastases was not confirmed by radiology or a scan. Bone metastases would have been missed in only 14 patients (1.9%) without a skeletal scan. Eleven of these 14 patients were in high-risk groups (negative hormone receptor status; axillary lymph node metastases). Skeletal metastases were undiscovered in only three of the 750 patients (0.4%). It is thus sufficient to limit skeletal scans to high-risk groups, as long as a careful history of pain is taken and a thorough clinical examination conducted.

Out of 1220 (100%) cases of endometrial carcinomas, registered at the Klinik Bad Trissl during a period of 20 years (1968-1988), over 127 cases (10.4%) of double and triple malignomas were found. 86 cases (7.0%) are correlated with a second primary breast cancer, 41 (3.4%) with other primary malignomas. 14 cases (1.1%) show triple malignomas. 8 precancerous cases (0.7%) were included in the survey. Contrary to medical literature the survey reveals a different distribution of neoplasms among the affected organs. Four fifths of the tumour combinations were located in the female genital tract including the breast. Therefore the early detection of potential secondary malignomas should be included in the aftercare of endometrial cancer.