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Introduction: The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common cause of hyponatremia in cancer patients, occurring most frequently in patients with small cell lung cancer. However, this syndrome occurs extremely rarely in patients with non-small cell lung cancer. The results of the clinical trials have revealed that immuno-oncological therapies are effective for long periods of time, providing hope for long survival and with a good quality of life. Case Presentation: We present the case of a female patient who was 62 years old at the time of diagnosis in 2016 who underwent surgery for a right pulmonary tumor (pulmonary adenocarcinoma) and subsequently underwent adjuvant chemotherapy. The patient had a left inoperable mediastinohilar relapse in 2018, which was treated using polychemotherapy The patient also had an occurrence of progressive metastasis and a syndrome of inappropriate antidiuretic hormone secretion (SIADH) in 2019 for which immunotherapy was initiated. The patient has continued with immunotherapy until the time this study began to be written (April 2023), the results being the remission of hyponatremia, the clinical benefits and long-term survival. Discussion: The main therapeutic option for SIADH in cancer patients is the treatment of the underlying disease, and its correction depends almost exclusively on a good response to oncological therapy. The initiation of immunotherapy at the time of severe hyponatremia occurrence led to its remission as well as the remission of the other two episodes of hyponatremia, which the patient presented throughout the evolution of the disease, demonstrating an obvious causal relationship between SIADH and the favorable response to immunotherapy. Conclusions: Each patient must be approached individually, taking into account the various particular aspects. Immunotherapy proves to be the innovative treatment that contributes to increasing the survival of patients with metastatic non-small cell lung cancer and to increasing their quality of life. [ABSTRACT FROM AUTHOR]

Currently, the treatment of malignant melanoma offers the longest and the most studied experience of innovative treatments in malignant pathology. The algorithm of the therapeutic decision in advanced or metastatic melanoma must comprise: the timing of the therapeutic initiation, the sequencing of the specific oncological treatment (radiotherapy and chemotherapy still being therapeutic alternatives in selected cases), the diagnosis and the management of adverse reactions. We present the case of a patient diagnosed with metastatic malignant melanoma in November 2019, who progressed successively under new systemic treatment throughout the 3 years of treatment and experienced skin reactions of various degrees of severity. The comprehensive response to secondary hilar pulmonary lymphatic determinations under subsequent chemotherapy was specific to the presented case. The occurrence of vitiligo secondary to immunotherapy is a favorable prognostic factor, but the occurrence of secondary cerebral determinations is an extremely severe prognostic factor in malignant melanoma and a challenge in making the therapeutic decision. Previous treatment with immune checkpoint inhibitors may trigger a favorable response to systemic chemotherapy. The early and accurate diagnosis of the adverse events of the new therapies requires a multidisciplinary approach, because it can radically change the therapeutic decision. [ABSTRACT FROM AUTHOR]

Background: Rectal cancer is one of the most common malignant pathologies worldwide. Currently, the standard treatment of this pathology consists of radio‑chemotherapy followed by low anterior resection with total mesorectal excision or abdominoperineal proctectomy for medium/low rectal cancer. Objectives: In recent years, another treatment strategy has been proposed, stemming from the finding that up to 40% of patients receiving neoadjuvant treatment had a complete pathological response. This method, also referred to as the watch and wait approach, implies delaying surgery and following a rigorous protocol for patients who have developed a complete response to neoadjuvant treatment with a good oncologic outcome. The objective of this study was to highlight the merits of this approach in selected patients. Case Reports: In this study, we present two patients with low‑rectal tumors who developed complete response post neoadjuvant therapy and for whom the watch and wait protocol has been applied over the past 4 years. Conclusion: Although the watch and wait protocol appears to be a feasible option in the management of patients with a complete clinical and pathological response post neoadjuvant therapy, more prospective studies and randomized trials comparing this approach with standard surgical treatment are required before establishing it as the standard of care for distal rectal cancer. Therefore, establishing universal criteria for the selection and assessment of the patients with a complete clinical response following neoadjuvant treatment is required. [ABSTRACT FROM AUTHOR]

Tarsal tunnel syndrome (TTS), or tibial nerve compression at the internal malleolus level, is a frequently missed disease among clinicians, although it can be found in diabetic patients (almost half of them will develop peripheral neuropathy and related complications) and in non-diabetic patients due to the existence of tumors and anatomical accessory elments. The aim of this paper is to increase the level of awareness regarding the TTS diagnostic tools and treatments among doctors. The main source of literature review was PubMed database and the author’s personal experience. Although it is considered a rare disease, for sure underdiagnosed, left without treatment, TTS will lead to foot sensitive and motor deficits with dramatic effects on patients quality of life and survival. Patient’s history, clinical examination (positive Tinel sign, objective testing of increased sensibility threshold) and paraclinical examination (soft tissue ultrasonography and nervous conduction studies) highlight the diagnostic. The conservative and minimally invasive therapeutic methods are efficient, but limited in time, the surgical solution – tarsal tunnel decompresion – being still the elective procedure, even in critical peripheral neuropathy [ABSTRACT FROM AUTHOR]

Injuries to the upper limb may determine unexpected simple or complex soft tissue defects, due to different types of underlying injury mechanism, clean cut/stabs, crushing, torsion, avulsion or mixed types, which pose a challenge for the reconstructive surgeon. Ideally, all arterial, venous and nervous lesions, in the distal upper limb should be repaired in an end-to-end technique, outside of injury zones, with healthy ends, in a tension free manner. However, situations arise where, either a tension-free repair is not possible, or a considerable defect is met, often representing a challenge to the surgeon. Therefore, a timely decision is imposed in order to find the most favorable approach to restore limb or segment perfusion, ensuring efficient venous return, as well as providing a sensate repair. Usage of vein grafts represents an essential tool comprised in the reconstructive surgeon’s armamentarium, with high versatility in nerve, arterial and venous reconstruction. Not only does it provide an ideal solution, with high adaptability to each case, but it also may enhance short- and long-term outcome, offering an optimal reconstructive option in any upper limb trauma situation, regardless of etiology. We aim to describe our therapeutic strategies in a series of challenging trauma cases involving digital structures from the upper limb. Interposed vein grafts were used to re-stablish sensate function in a patient with a collateral digital nerve defect, but also to bridge vital digit arterial defect in a torsion-avulsion thumb amputation, as well as re-establishing venous flow in patients with Urbaniak II finger degloving injury. [ABSTRACT FROM AUTHOR]

Traditional modality of using public property, the concession has played a significant role in the development of the modern state by capitalizing on those goods that by their legal nature have an inalienable character as well as by entrusting some works or public services to legal entities of private law which can execute them or make them more efficient. The economic development of the last decades of the states of the European Union, the acceleration of the commercial exchanges and the extension of the forms of circulation of the goods and services at community level have determined the reconsideration of the concession contract as a legal instrument for the capitalization of the public property goods, of the works and services that the state owns. The consolidation, at national level, of some legal norms meant to regulate concession and its forms was significantly influenced by the provisions of Directive 2014/23/EU of the European Parliament and of the Council of 26 February 2014 on the award of concession contracts. Thus, Law no. 100/2016 regarding the concession of works and services as well as the recent Government Emergency Ordinance no. 57/2019 on the Administrative Code implement the new European vision. [ABSTRACT FROM AUTHOR]

Considered to be one of the most important functions of the state, the national defense encompasses all the measures adopted both in peacetime and in crisis or war situations in order to guarantee the national sovereignty, independence and unity of the state. An appropriate training for the complexity of a crisis situation can not exclude the proper legal foundation, because without a well-built legislative structure the response to a threat against the state may be delayed or inexistent. In order to ensurethe normative framework, alongside the Romanian Constitution, the Government Emergency Ordinance no. 1/1999 offers, even with small gaps, the legal elements necessary for the realization of a unitary system of response to crisis in which various public, civil and military authorities intertwine their attributions in the establishment and implementation of siege-specific measures. [ABSTRACT FROM AUTHOR]

The application of the measures and the carrying out of activities specific to defence are ensured by the public authorities of the Romanian state, of which the authorities of the public administration play a vital role. In addition to the Parliament and to the President of Romania, the representative authorities in which the will of the people is expressed directly, the authorities of the local and central public administration, through their exercised powers, enforce the Constitution and the laws and guarantee the existence of an effective national defence system. [ABSTRACT FROM AUTHOR]

With a distinguished role in the construction of the European identity, the principle of subsidiarity represents one of the most important principles specific to the European Union. Next to the principle of proportionality, the subsidiarity was included among the principles, which govern and control the delimitation and the execution of the competences, so that in the areas that are not of their exclusive competence, the Union intervenes only if the objectives of the proposed action cannot be satisfactory realized by the Member States not only on a central level but also on a local or regional level but can better realized on the level of the Union. Transferred in the area of the public administration as a veritable premise for an efficient administration, the principle of subsidiarity assures the execution of the compet ences by the authority of the local public administration on the administrative level closest to the citizen. [ABSTRACT FROM AUTHOR]

The field of transplantation, including the specialized area of vascularized composite allotransplantation (VCA), has been transformed since the first hand transplant in 1998. The major challenge in VCA comes from the need for life-long immunosuppressive therapy due to its non-vital nature and a high rate of systemic complications. Ongoing research is focused on immunosuppressive therapeutic strategies to avoid toxicity and promote donor-specific tolerance. This includes studying the balance between tolerance and effector mechanisms in immune modulation, particularly the role of costimulatory signals in T lymphocyte activation. Costimulatory signals during T cell activation can have either stimulatory or inhibitory effects. Interfering with T cell activation through costimulation blockade strategies shows potential in avoiding rejection and prolonging the survival of transplanted organs. This review paper aims to summarize current data on the immunologic role of costimulatory blockade in the field of transplantation. It focuses on strategies that can be applied in vascularized composite allotransplantation, offering insights into novel methods for enhancing the success and safety of these procedures. [ABSTRACT FROM AUTHOR]

Background: COVID-19 is an infectious disease caused by the new coronavirus, SARS-COV-2. Elderly patients, those with comorbidities such as cardiovascular disease, diabetes, chronic respiratory disease or cancer, are more likely to develop more severe forms of the disease. During COVID-19 pandemic, cancer patients wanted to continue the oncological treatment, this being a priority for them. Material and method: We evaluated the medical records of all patients hospitalized in the Chronic Oncology-Palliative Care Department of the Chronic Diseases Hospital "St. Luke" Bucharest, during a period of 8 weeks of emergency (15.03-8.05, 2020). Between 25.04-8.05, the testing for SARS-CoV-2 was performed, by RT-PCR method, of all the asymptomatic patients hospitalized in the department. Discussion: Delaying oncological treatments, as well as delaying palliative care for cancer patients, can have repercussions on disease progression, overall survival, and quality of life (treatment of symptoms with an increased frequency of cancer, such as pain syndrome, nausea and vomiting, cannot be delayed). However, delaying active cancer treatments cannot be recommended as an option to reduce the risk of pandemic infection. Conclusions: During the COVID-19 global pandemic, between 15.03 and 8.05, 2020, our department ensured the continuity of oncological treatments and palliative care for cancer patients. No patients admitted to our ward were positively diagnosed for SARS-CoV-2 virus infection until May 08, 2020. [ABSTRACT FROM AUTHOR]

Introduction: Prostate cancer has no initial clinical manifestation in the case of brain metastases since they are asymptomatic at first. This is why there is a high risk for clinicians to overlook these lesions, and they are often confused with other diseases. With all the improvements in diagnostic technological methods, which allow the early detection of lesions, and the progress in terms of systemic therapy associated with increased survival, an increase in incidence has also been noticed. Materials and methods: We report the case of a 64-year-old patient who presented himself to the Oncology Department of "St. Luca" Chronic Disease Hospital in Bucharest in November 2011 and received the following diagnosis: biopsied prostate neoplasm, local-regionally advanced, pelvic lymph node metastases. Results: After receiving complex oncological treatment, this patient represents a rare case of long-term progression-free survival (15 years). Discussions: This case has some particularities. According to the literature data, survival with metastatic prostate cancer is approximately 21 months, and cerebral metastases are found in only 2% of prostate cancer cases. This case is one of the few cases in the specialty literature that benefited from all therapeutic sequences; namely, total androgenic blockade, docetaxel, abiraterone, enzalutamide, and cabazitaxel. Conclusions: Brain metastases are an unfavorable prognostic factor in prostate cancer. The therapeutic options developed in recent years allow the improvement of survival. [ABSTRACT FROM AUTHOR]

Nerve entrapment syndromes in the upper extremity represent a common occurrence, but in many cases these are not correctly diagnosed, leading to severe complications. Carpal tunnel syndrome is the most frequent compressive syndrome. The promptitude in establishing a correct diagnosis and initiating an adequate treatment is essential in reducing the morbidity associated with nerve compression in upper limb, improving the quality of life of the patient and also ensuring a faster socio-professional reinsertion. Nerve lesions demonstrate a variable evolution, with different recovery and prognosis. We developed a prospective clinical study with the aim to evaluate a series of patient characteristics that influence the disease evolution and may serve as predictive factors for treatment outcome in compressive neuropathies. Further manipulation of those parameters may direct our therapeutic strategies for obtain a maximal functional recovery, the supreme desiderate in peripheral nerves pathology. [ABSTRACT FROM AUTHOR]

Skin cancer represents the most frequent type of human malignancy. Skin poses an important immunologic role, therefore also the correlation between skin cancer development and immunologic mechanisms are intensely studied. These aspects are of the utmost importance in patients requiring immunosuppressive therapy as transplant recipients or immunologic disorders. Cancer development after organ transplantation is the result of intense intercommunication between immunological and nonimmunological factors. Non-immunologic risk factors like individual predisposition, sun and environmental exposure are a contributing part to the skin neoplasia incidence. In addition, continuous exposure to immunosuppressive medication is closely linked to the development of the new malignancy. A similar situation is encountered in autoimmune diseases, those patients having an increased risk of skin cancer, especially squamous cell carcinoma. Immunotherapy shows promising results and encourages further studies in this direction. Also, an important aspect is to support preventive strategies in patients with high risk of skin cancer development. [ABSTRACT FROM AUTHOR]

Nerve entrapment syndromes in the upper extremity represent a common occurrence, but in many cases these are not correctly diagnosed, leading to severe complications. Carpal tunnel syndrome is the most frequent compressive syndrome. The promptitude in establishing a correct diagnosis and initiating an adequate treatment is essential in reducing the morbidity associated with nerve compression in upper limb, improving the quality of life of the patient and also ensuring a faster socio-professional reinsertion. Nerve lesions demonstrate a variable evolution, with different recovery and prognosis. We developed a prospective clinical study with the aim to evaluate a series of patient characteristics that influence the disease evolution and may serve as predictive factors for treatment outcome in compressive neuropathies. Further manipulation of those parameters may direct our therapeutic strategies for obtain a maximal functional recovery, the supreme desiderate in peripheral nerves pathology. [ABSTRACT FROM AUTHOR]

Tumor nerve compressions in the upper limb are relatively rare, usually involving ganglion cysts and benign tumors. We present a case series of five patients with peripheral nerve compression in the upper limb due to tumor or cystic masses- ulnar nerve compression in the Guyon’s tunnel due to a ganglion cyst, large median nerve schwannoma compressing anterior interosseous nerve and median nerve, voluminous lipoma compressing median nerve in the proximal forearm, superficial branch of radial nerve compression by a synovial cyst and elbow region lipoma compressing radial nerve. In the beginning, those benign lesions are asymptomatic but, as they continue to grow adjacent to a peripheral nerve clinical manifestations appear progressively as compressive neuropathies. After a preoperative imagistic analysis, tumor resection with careful dissection, in order to preserve the neurovascular structures, is the elective surgical procedure in order to obtain an optimal functional recovery. [ABSTRACT FROM AUTHOR]

Lymphedema represents a chronic condition with impaired lymphatic transport, having primary and secondary etiologies. The most common type of secondary lymphedema in western countries is represented by breast cancer related upper limb lymphedema. This condition, once installed, determines limb structure changes, progressive functional impairment, specific complications, consequently impacting the quality of patient’s life. An accurate diagnosis is mandatory, using both clinical and imagistic methods with clear definition disease extent as per standardized staging systems, in order to further provide an adequate therapeutic strategy. The main therapeutic goal in patients with lymphedema is represented by limb volume reduction with subsequent symptoms relief, improving quality of life and avoiding complications such as recurrent infections. Through this paper, we aim to present a comprehensive overview of current therapeutic options of breast cancer upper limb related lymphedema. Therapeutic approach comprises of non-surgical (conservative) therapy, which is mandatory as initial therapy and surgical procedures for selected cases. Most patients with lymphedema benefit from conservative treatment alone. In non-responsive cases, in patients with progressive disease, in late stage complicated lymphedema, and also recently added as prophylactic strategy, surgical treatment, trough recent developed techniques, offer very good results in long-term control of disease. Surgical options are classified firstly in physiologic procedures that aim to create new lymphatic channels, promote physiologic drainage of the lymph and should be considered early in the course of the disease, and secondly ablative procedures that reduce through liposuction or various excision techniques the volume of the affected limb. Both types of techniques can be combined to ensure the best functional outcome of the patient. [ABSTRACT FROM AUTHOR]

Upper limb trauma cases vary from simple to high energy impactful injuries, with different etiologies; situations which frequently require unique, demanding and challenging endeavors in order to obtain the most favorable outcome. Experience, good decision-making and knowledge of functional goals are mandatory in order to elaborate a therapeutic plan and execute it accordingly. Although cases differ in nature and prognosis, respecting a set of therapeutic principles whilst dealing with either simple or complex cases, will enhance patient outcome and give the surgeon the confidence to tackle any kind of upper limb trauma. After clearing out vital threat, the emergency surgery represents the first threshold in achieving and restoring normal function and biomechanics, mostly in young and labor active patients, with the mindset to salvage as much tissue as possible, with a thorough debridement and step-by-step approach to different types of tissues. Secondary surgery and reconstructive surgery can be planned timely, with prior discussion with both the therapist and the patient in order to enhance patient’s upper limb function and aesthetic and ensure social reintegration. [ABSTRACT FROM AUTHOR]

Background: The front-line medical staff is mainly at risk of becoming infected with the new coronavirus. Material and method: The psycho-emotional impact on the care team after the diagnosis with COVID-9 of the team members was evaluated by 2 questionnaires. Results: Over a period of 2 weeks 25% (9/36) team members were diagnosed with COVID 19. From the moment of testing until the moment of finding out the result, the staff presented feelings of fear and anxiety. During the illness and hospitalization the health-care staff experienced feelings as: disappointment, depression, frustration. Discussion: Screening testing for asymptomatic individuals associated with obligation and a long period of hospitalization causes significant psycho-emotional distress among health-care staff. Conclusions: The experience of SARS CoV 2 infection in a small palliative care team has demonstrated the need for protective measures, and courage and confidence are the balancing elements to face critical moments. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic was and still is a great challenge for the entire world population. People in the first line, among them doctors being a very important category, faced the risk of disease and, in some cases, even became infected. The emotional consequences of this risk are highlighted in this paperwork which tries to stress, with the help of applied questionnaires, the presence of psycho-emotional disorders among the medical staff of the Oncology Department of St. Luke's Hospital, Bucharest, during the pandemic. The medical staff had a low level of stress, adapting to the evolution of the pandemic "to some extent". The main fear was that of illness and the most common emotional states experienced by the subjects were: worry, nervousness and dissatisfaction. Most of the medical staff showed negative emotions, but there were also people who felt positive emotions of relaxation, calmness or joy. The most common ways of managing the stress caused by the pandemic were: communicating with colleagues, family and friends, watching movies and enjoying various activities with the family at home. [ABSTRACT FROM AUTHOR]

Burn injuries are unique in comparison to other types of trauma because of their severity and major systemic impact produced by extensive lesions with disfunctions that can persist even several years after the injury. Multiple complications can occur during burn injury evolution, from which infections are the most severe and the most frequently encountered, requiring adequate diagnosis and treatment. In most burn centers, increased mortality rates associate with severe burn injuries aggravated by the development of sepsis. There are multiple sources of infections in burned patients: lungs, wounds, catheters, gastrointestinal and urinary tract. Pathogens are often multi-resistant bacteria but also fungi and viruses appear as opportunistic infections. The main goal is represented by prevention of organ dysfunction development through specific supportive measures that avoid its onset. Early excision of the burn eschar and wound grafting is essential for patient outcome, decreasing duration of hospitalization, infectious risk and mortality. As a principle, antibiotic treatment in burn infectious complications is started empirically, with broad spectrum agents if the results of microbiological cultures are not available and immediately after the antibiogram is available, targeted antibiotic is introduced. De-escalation strategy is promoted in order to prevent antimicrobial resistance: narrow spectrum drugs with proven efficacy on determined germs are administered, avoiding if possible, reserve antibiotics. [ABSTRACT FROM AUTHOR]

Severe burn injuries represent a major challenge to the entire healthcare system in developing countries and even for states with a high standard of care. A clear understanding of the physiopathology of burn injuries is essential for providing an adequate prompt treatment to ensure an optimal patient outcome. Early recognition and treatment of burns complications, especially severe infections represent an important prevention strategy, improving survival after these severe injuries. Specific treatment must be conducted according to the characteristics of the patients in order to reduce morbidity and mortality and avoid the development of antimicrobial resistance. A diagnostic and therapeutic algorithm is presented, centered on infectious source prevention and control with early surgical excision and skin grafting together with culture-guided antimicrobial therapy. It is a known fact that, indifferent of the involved germ, the best intervention for both prophylaxis and treatment of infections in the burn patient is the early excision of the devitalized tissue and subsequent closure of burn wounds with skin grafts, measures that diminish local and systemic mediator releasing effects in burnt tissue, attenuating the progressive inflammatory chain. [ABSTRACT FROM AUTHOR]

Anastomotic leaks are the most serious complication of colo-rectal surgery, generating significant morbidity and mortality rates. We performed a 6-year retrospective study in which we included patients who developed anastomotic colo-rectal fistulas after resections for malignant disease. We assessed the risk factors for this complication, its management and results. Twenty-two patients aged between 34 and 82 years were enrolled, with an equal number of males and females (11). Following the surgical procedures, 4 types of anastomotic leaks resulted: ileo-colic (6 cases), colo-colic (8 cases), colo-rectal (5 cases) and low colo-rectal (3 cases). Conservative management was applied for 10 patients while the other 12 required surgical treatment. The overall mortality of this study group was 13.6%. Better optimisation of surgical procedures and preoperative patients' comorbidities might decrease the rate of this complication. Therapeutic management is not standardised but adapted to each patient's condition, but conservatory management should be initiated to all eligible patients. [ABSTRACT FROM AUTHOR]

Autorii prezintă câteva soluţii pentru implementarea standardelor etice la locul de muncă în sistemul de sănătate. Este menţionată o serie de norme de conduită, tipuri de reguli (ce vizează responsabilitatea salariaţilor faţă de organizaţie, relaţiile cu clienţii şi legea). Se subliniază valorile care pot sta la baza elaborării şi aplicării corecte a unui sistem de reguli şi sancţiuni (specificitate, claritate, justiţie, transparenţă, etc.). Instituţionalizarea principiilor etice se poate face prin întocmirea unui contract (scris, dar şi psihologic) între organizaţie şi salariaţi, prin întărirea angajamentului organizaţional, prin consolidarea culturii organizaţionale. [ABSTRACT FROM AUTHOR]

Objectives. The number of patients developing multiple primary cancers, synchronous or metachronous, has been increasing during the last couple of years. Literature considers that this increase is due to the development of the medical diagnosis techniques, the treatment and monitoring of neoplastic patients, known as having a higher risk of developing a second neoplasia compared to the risk of the general population; the increase in the average life expectancy of modern population is also added to such. Description. We present the case of a 73-yearold Caucasian patient, former smoker for 15 years, diagnosed in January 2016 with a routine CT scan, with two lung lesions in the upper right lobe. The pathological history of the patient shows two synchronous neoplasias of cecum and descending colon treated radically: sequential resection and adjuvant chemotherapy. After a disease-free period of 8 years, in January 2016, two spiculiform lung lesions are discovered in the upper right lobe, suspected of being tuberculosis lesions. The patient had undergone tuberculostatic treatment for 5 months, under which it was discovered that the lung lesions grew. After a PET-CT reassessment, which notices the increased metabolic activity of the lung lesions, a surgical treatment is decided - LASER assisted non-anatomic resection. The extemporaneous histopathological examination shows a carcinomatous infiltration for both lesions, but the parafin histopathological examination shows two different results: lung squamous carcinoma and lung metastasis of malignant melanoma - results confirmed by the immunohistochemical analysis. The dermatologic examination uncovered a melanomatous lesion in the nail bed in the second toe of the left foot, for which the resection of the intermediate and distal phalanges was performed. The histopathological examination confirms a Clark stage III malignant melanoma. Conclusions. We consider that the association of two synchronous cancers of colon with a metachronous lung cancer and an oligometastatic melanoma is rare, and has not been reported in literature according to our knowledge. Due to the increased risk of developing a second malignancy, patients with neoplasias require long-term follow-up, and the cases with multiple malignancies are subject to a customised multimodal treatment plan. [ABSTRACT FROM AUTHOR]