Multiple primary malignancies in different organs and tissues in the same patient are rarely encountered. Among of all the patients with a malignancy, a new primary neoplasm may develop during and/or after treatment. The incidence of more than two primary malignancies is much lower. Primary lung carcinoma was common for either case. In this article, we present two cases with triple and quadruple primary malignancies detected both metachronously or synchronously. The first case had renal adenocarcinoma and medullary thyroid carcinoma, and the second case had prostate adenocarcinoma, basal cell carcinoma of the skin, malignant solitary fibrous tumor of the mediastinum, both accompanied lung carcinoma.