Multiple primary malignant neoplasms (MPMNs) are rare in daily clinical scenario, however, occurrence of Soft Tissue Sarcomas(STSs) post treatment are among rarest of incidences.

A 61 year old female with complaints of malena and severe abdominal pain since December 2007 and was diagnosed with Colonic Adenocarcinoma. With associated complaint of severe menorrhagia for similar duration, she underwent extended right hemicolectomy (with ileocolic anastomosis) with total abdominal hysterectomy and bilateral salpingo–oophorectomy (TAHBSO) with bilateral pelvic node and retroperitoneal lymph node dissection. The HPE showing Endometrial Adenoarcinoma.

From January 2008, she received six cycles of Adjuvant chemotherapy and was put on regular monthly follow–up thereafter with another review colonoscopy (July 2009), findings within normal limit . She became lost to follow–up after November 2009. She presented with a hard lump over the calf region of her left leg in October 2016 and underwent a local resection without HPE. The lump recurred over anterolateral surface of her left leg in April 2017. She underwent an excisional biopsy and metastatic workup. The HPE showed High Grade Pleomorphic Sarcoma and CECT abdomen showed features of metastatic disease. The lump being fungating, she underwent a palliative resection and is currently receiving palliative chemotherapy.

We present a rare case presenting with soft tissue sarcoma along with lung metastasis after a disease free interval (DFI) of almost 7 years being treated for synchronous double primary colon and endometrial cancer.