Case Report Case Report of Synchronous Prostate, Hepatocellular, and Rectal Carcinomas and Review of the Literature Viktoria Lamprou , 1 Daniel Paramythiotis , 2 Dimitrios Giakoustidis , 3 Anestis Karakatsanis , 2 Athanasios Astreinidis , 1 Moysis Moysidis , 2 Antonios Mihalopoulos , 2 and Stefanos Finitsis 1 1 Department of Interventional Radiology, University General Hospital of Thessaloniki AHEPA, Thessaloniki 546 21, Greece 2 1st Propaedeutic Surgery Department, University General Hospital of Thessaloniki AHEPA, Thessaloniki 546 21, Greece 3 1st Surgery Department, Aristotle University of Thessaloniki, General Hospital Papageorgiou, Thessaloniki 56403, Greece Correspondence should be addressed to Viktoria Lamprou; victorialambrou@gmail.com Received 10 October 2019; Accepted 10 January 2020; Published 22 January 2020 Academic Editor: Christophoros Foroulis Copyright © 2020 Viktoria Lamprou et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Synchronous occurrence of three histopathologically distinct malignant tumors is a rare event, and there are no definitive guidelines about the optimal treatment of these patients. We report a case of synchronous prostate, hepatocellular, and rectal carcinomas and discuss our therapeutic strategy that resulted in excellent clinical results. 1. Introduction Synchronous malignancies are defined as tumors diagnosed within two to six months of the initial diagnosis of a primary tumor and occur in 0,002% to 1,96% of cancer patients [1, 2]. This frequency is increasing despite a general decline in can- cer deaths since 1991 because of the increased lifespan of the general population secondary to proper screening, earlier diagnosis, improvements in treatment, and surveillance of patients [3]. Management of synchronous cancers is chal- lenging [4]. We present a patient with synchronous liver, colorectal, and prostate cancers treated by a multidisciplinary approach with an excellent clinical outcome. 2. Case Presentation A 67-year-old man presented with a history of change of bowel habits, blood in stool, and weight loss. His past medical history included only tobacco and alcohol use. According to his family history, two of his first-degree relatives had devel- oped colonic cancer. A colonoscopy revealed the presence of a 4 cm mass approximately 10 cm from the anal verge and was confirmed to be a well-differentiated colon adenocarci- noma at a biopsy. Laboratory tests showed elevated serum carcinoembryonic antigen (CEA) (8,07 ng/ml), elevated serum prostate-specific antigen (PSA) (17,87 ng/ml), and elevated α-FP (17,9 ng/ml). The patient was seronegative for HBsAg and anti-HCV (IgM and IgG). His liver func- tion tests were within normal limits. The abdominal MRI showed the presence of an 11 × 10, 5 × 10, 5 cm mass in the right hepatic lobe, with radiologic features consistent with a primary liver lesion (Figures 1 and 2). The CT- guided liver biopsy revealed a well-differentiated hepato- cellular carcinoma. Additionally, because of the elevated PSA values, a prostate biopsy was performed. Seven core biopsies were taken from the left prostatic lobe and eight from the right lobe, and all of them were positive for pros- tatic adenocarcinoma (Gleason score 3 + 4 = 7/10). Given the patient’s good performance status, surgical resection for the hepatocellular carcinoma was considered. However, because of the small liver remnant, it was decided to first perform transarterial chemoembolization, to partially control the hepatocellular carcinoma (Figure 3). Two weeks later, the rectal carcinoma was treated by low anterior Hindawi Case Reports in Surgery Volume 2020, Article ID 6967428, 7 pages https://doi.org/10.1155/2020/6967428