Synchronous ipsilateral renal cell carcinoma and urothelial carcinoma of kidney in a patient with prostate adenocarcinoma: A case report and review of literature
Chu-Wen Fang, Bai-Fu Wang, Jian Ting Chen, Pao-Hwa Chen, You-Chiuan Chien, Chin-Wei Kuo
Division of Urology, Department of Surgery, Changhua Christian Hospital, Taiwan
Single occurrence of renal cell carcinoma (RCC) or urothelial carcinoma (UC) of the upper urinary tract is frequent urological malignancy. However, synchronous and simultaneous occurrence is rare, particularly in a patient with prostate adenocarcinoma. Herein, we report a case of synchronous ipsilateral RCC and UC of kidney in a patient with prostate adenocarcinoma.
A 76 year-old male with old pulmonary tuberculosis suffered from left flank pain for several months. MRI reveals a mass lesion about 6.4 * 5.4 cm in lower pole of left kidney, in favor of RCC. cT1bN0M0. Then he received robot-assisted laparoscopic radical nephrectomy. The intraoperative finding includes left side renal tumor over lower pole and posterior aspect with engorged tumor supplying vessels. The pathology reported as clear cell RCC with free margin (pT3aN0) and infiltrating UC (pT1) over renal pelvis. With elevated PSA (27.92 ng/mL), he also received transrectal ultrasound and biopsy. All the apex, middle, and base of left lobe are adenocarcinoma with Gleason's score 5+4=9. MRI reveals a heterogeneous low signal intensity lesion on the peripheral zone of left lobe of prostate on T2WI, and suspected tumor invasion into left seminal vesicle. There was no bone metastasis (T3bN0M0). He currently received combined radiotherapy and androgen deprivation therapy.