Triple Threat: Three Primary Malignancies Simultaneously Involving Three Genitourinary Organs.
Katharina Mitchell1, Reima El Naili2, Lakshmikumar Pillai3
1West Virginia University Department of Urology, Morgantown, WV, USA.
Case Reports in Urology
|April 27, 2023
Summary
This case report details an extremely rare occurrence of three distinct cancers: renal cell carcinoma (RCC), urothelial carcinoma of the bladder (UC), and a renal neuroendocrine tumor (NET). The patient presented with symptoms of these concurrent malignancies.
Area of Science:
- Oncology
- Urology
- Pathology
Background:
- Concurrent malignancies are rare, with the simultaneous occurrence of renal cell carcinoma (RCC), urothelial carcinoma of the bladder (UC), and renal neuroendocrine tumor (NET) being exceptionally uncommon.
- This report highlights a statistically improbable case, emphasizing the importance of comprehensive diagnostic evaluation in complex presentations.
Observation:
- A 67-year-old female presented with bilateral flank pain and gross hematuria.
- Imaging revealed bilateral renal masses and a paracaval lymph node. Cystoscopy identified a bladder tumor.
- Biopsies confirmed clear cell RCC (left kidney), well-differentiated NET (right kidney), and high-grade nonmuscle invasive UC (bladder).
Findings:
- Final pathology confirmed three distinct malignancies: noninvasive high-grade papillary UC (pTaN0), left renal clear cell RCC (pT2bN0), and right renal well-differentiated NET with metastatic disease to a paracaval lymph node (pT2aN1).
- The patient underwent bilateral nephroureterectomy, radical cystectomy, and lymphadenectomy.
Implications:
- This case underscores the possibility of multiple, rare primary malignancies occurring concurrently in a single patient.
- It highlights the need for thorough investigation of complex urological and renal symptoms, even in the face of statistically improbable diagnoses.
- Such rare occurrences contribute valuable data to understanding cancer development and presentation.
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