Multiple primary malignant neoplasms (MPMN) is the term used to describe malignancies arising from two or more different organs with different histology and have no relation which each other. Incidences of such cases have been occasionally in the literature. Organs affected in such cases do differ in accordance to prevalence of disease in the particular region, with metachronous occurrences being more common than synchronous malignancies. Carcinoma gall bladder and Carcinoma cervix are the two most common neoplasms affecting the females in Northern India. The synchronous appearance of both malignancies together is a rare phenomenon which has never been described earlier in available literature search. We describe synchronous occurrence of locally advanced adenocarcinoma gall bladder with locally advanced squamous cell carcinoma cervix and the diagnostic as well management challenges we encountered in this case report. 50 year old post menopausal female presented with complains of pain in right upper abdomen with a palpable abdominal lump and foul smelling vaginal discharge. On examination there was a lump in right hypochondrium with an ulcerative proliferative growth in cervix. Radiological imaging showed gall bladder mass with adjacent hepatic infiltration and cervical growth invading base of bladder and right parametrium causing right hydrouteronephrosis. Image guided core needle biopsy of gall bladder revealed adenocarcinoma and punch biopsy of cervix revealed squamous cell carcinoma. With increasing life expectancy and improvement in imaging modalities there is a gradual increase in reporting of such cases. Proper Clinical assessment is needed to rule out recurrence in case of metachronous malignancies or metastasis in case of synchronous malignancies from index cancers to classify it as multiple primary malignant neoplasms. These cases not only pose a diagnostic dilemma but also difficulty in management. With more awareness and better reporting regarding the phenomena we may be able to formulate personalized treatment plans to treat these patients of MPMN

Keywords: Synchronous; Multiple Primary Neoplasms; Carcinoma; Gall Bladder; Cervix.