[Triple cancer in the urinary system: a case report]

Area of Science:

• Urology
• Oncology
• Medical Case Reports

Background:

• A 74-year-old male presented with asymptomatic microhematuria.
• Initial investigations revealed multiple small bladder tumors, right kidney abnormalities, and left renal pelvis defects.
• The patient was also diagnosed with prostate carcinoma.

Observation:

• A 74-year-old male presented with microhematuria, leading to the discovery of multiple papillary bladder tumors.
• Imaging revealed a large right renal tumor invading the renal vein and a left renal pelvis tumor, alongside prostate carcinoma.
• The patient underwent radical nephrectomy, nephroureterectomy, and cystectomy for the extensive urinary tract malignancies.

Findings:

• The patient was diagnosed with synchronous urothelial carcinoma of the bladder and renal pelvis, and prostate adenocarcinoma.
• The bladder tumors were suspected to be secondary to the renal pelvic tumor, suggesting a 'triple cancer' diagnosis.
• This represents the 11th reported case of multiple urinary tract malignancies and the first requiring total urinary tract resection.

Implications:

• This case highlights the complexity of managing synchronous upper and lower urinary tract malignancies.
• The findings underscore the importance of thorough diagnostic evaluation for patients presenting with hematuria and multiple urinary lesions.
• Complete urinary tract resection may be necessary in rare, advanced cases of synchronous urothelial cancers.