[Synchronous renal clear-cell carcinoma and ipsilateral transitional-cell carcinoma: case report and bibliographic review]

Chromophobe renal cell carcinoma with ipsilateral ureteral urothelial carcinoma: A case report

It is very rare for different types of urological tumours to occur together, and it is even rarer for chromophobe renal cell carcinoma (CRCC) to be combined with ipsilateral ureteral urothelial carcinoma (UUC), and the symptoms are relatively homogeneous, mostly presenting as symptoms that can be observed in malignant tumours alone, and therefore are often easily missed. In the present study, a case of a patient who was admitted to the hospital for more than 3 months with no obvious cause of terminal carnivorous hematuria was reported, and ureteral carcinoma was considered in the preoperative diagnosis but not renal carcinoma. After completion of preoperative tests, laparoscopic right nephrectomy and right ureterectomy was performed. The postoperative pathological diagnosis was CRCC of the right side and low-grade UUC of the right side, and the patient did not show any significant abnormality at the postoperative follow-up. By discussing this case and reviewing the relevant literature, the present study provides clinicians with more insight.

Clinicopathological characteristics and outcomes of synchronous renal cell carcinoma and urothelial carcinoma: A population-based analysis

Background

To better understand the characteristics, and survival outcomes of synchronous renal cell carcinoma (RCC) and urothelial carcinoma (UC), we described and analyzed the clinical features, factors, and prognosis of patients with synchronous RCC and UC using a large population-based database.

Methods

Within the Surveillance, Epidemiology, and End Results (SEER) database (2004-2016), we identified patient with concurrent RCC and UC at initial diagnosis. Their clinicopathological features and prognosis were evaluated. A logistic regression model was used to examine risk factors for the occurrence of concomitant RCC and UC, and Kaplan-Meier survival curves were used to estimate overall survival.

Results

A total of 61,454 RCC patients were identified from the SEER database, 704 (1.1%) patients presented with synchronous RCC and UC. Among these patients, concurrent bladder tumors (566/704) are more common. Subsequently, subgroup analysis based on the location of UC indicated that patients with concurrent RCC and upper tract urothelial carcinoma (UTUC) had unfavorable UC characteristics (higher tumor stage and grade), compared with patients with concomitant bladder cancer. An increased risk of concurrent UC was observed among older age, male sex, and white race. Meanwhile, papillary RCC histology [odds ratio (OR) 3.23; 95% confidence interval (CI) 2.13-4.90], and smaller tumor (OR 6.63; 95% CI 4.46-9.87) were independent risk factors for concomitant UTUC. In addition, we found that synchronous RCC and UTUC was associated with worse survival by using Kaplan-Meier and multivariable analysis [hazard ratio (HR) 2.36, 95% CI 1.89-2.95]. However, concomitant bladder cancer did not affect survival outcomes of patients with RCC (HR 1.00, 95% CI 0.86-1.17).

Conclusion

We found that synchronous concurrent RCC and UC is relatively uncommon and mostly located in the bladder. Older age, male sex, and white race increase the risk of synchronous RCC and UC. Meanwhile, patients with papillary RCC histology, and smaller tumors are more likely to have concomitant RCC and UTUC. Furthermore, our findings suggest that synchronous RCC and UTUC has a worse prognosis, while, concomitant bladder tumor did not affect the oncological outcomes of RCC.

Pathologically diagnosed incidentaloma transition cell carcinoma (TCC) of renal pelvis in a laproscopic radical nephrectomy specimen done for a lower pole renal mass

We are reporting a very rare case in the current era of modern diagnostics of an incidentally detected Transitional Cell Carcinoma(TCC) renal pelvis, detected pathologically when Right laparoscopic radical nephrectomy specimen of lower pole mass(RCC) was processed, with no prior suspicion of TCC clinically or pre-operative imaging. A 75-year-old female with 4 × 4cm strongly enhancing lower pole renal mass on CTscan underwent a Laparoscopic Radical Nephrectomy. Surprisingly histopathological examination revealed a focus of low-grade TCC, arising from renal pelvis, completely separate from lower pole mass which was a clear cell RCC.

The first case report of synchronous primary papillary type 2 renal cell carcinoma of kidney and transitional cell carcinoma of bladder

Synchronous presentation of Multiple Primary Malignant neoplasms in genitourinary system is not a common event. Absolute majority of reported cases are concurrent outbreak of clear cell type renal cell carcinoma in the kidney and transitional cell carcinoma in ipsilateral renal pelvic. We reported concurrent presenting of two separate primary malignancies, urothelial cell carcinoma of bladder and papillary renal cell carcinoma Type 2 in kidney in a 59-year-old man for the first time.

Concurrent renal cell carcinoma and urothelial carcinoma: long-term follow-up study of 27 cases

BACKGROUND

To investigate the clinical manifestation, diagnosis, treatment, and outcome of simultaneous occurrence of renal cell carcinoma (RCC) and urothelial carcinoma.

METHODS

Twenty-seven consecutive patients with synchronous renal cell carcinoma and urothelial carcinoma treated in two tertiary medical centers from March 2005 to December 2015 were retrospectively reviewed. Their clinical, pathological, and prognostic features were evaluated. Kaplan-Meier curves were used to estimate overall survival.

RESULTS

The median age was 69 years (range, 37-79 years). Seventeen patients presented with macroscopic hematuria, and 10 patients were asymptomatic. B-ultrasound, computed tomography (CT), and cystoscopy initially indicated RCC concurrent with ipsilateral upper tract urothelial carcinoma (UTUC) in 5 cases, RCC concurrent with contralateral UTUC in 1 case, RCC concurrent with bladder tumor in 17 cases, RCC concurrent with both ipsilateral UTUC and bladder tumor in 1 case, RCC in 2 cases and ureter carcinoma in 1 case. Different treatments were performed. The median follow-up time after surgery was 23 months. For patients with synchronous RCC and bladder tumor, there was no significant survival difference between patients treated with partial nephrectomy and radical nephrectomy. During follow up, four patients died of RCC, three patients died of non-oncological disease, one patient died of ureter carcinoma. The 3-year overall survival rate was 80.8%.

CONCLUSIONS

Concurrence of RCC and urothelial carcinoma is clinically rare. Treatments should be individualized. The prognosis for a patient with synchronous RCC and urothelial carcinoma is possibly associated with the more aggressive one.

Synchronous Renal Neoplasm: Clear Cell Renal Cell Carcinoma and Papillary Urothelial Carcinoma in the Same Kidney

Abdominal computed tomography in a 64 year-old male presenting hematuria showed two malignant tumors in the left kidney, thus radical nephrectomy was realized. In histological preparations a clear cell renal cell carcinoma and a papillary urothelial carcinoma were identified occurring synchronously, which is a rare occurrence having only about 50 cases reported in the literature.

Primary carcinoma of the ureteral stump following radical nephrectomy for renal cell carcinoma: A case report and literature review

The occurrence of primary carcinoma of the ureteral stump following radical nephrectomy for renal cell carcinoma is extremely rare; 7 patients with the disease have been reported previously. All these patients were males with transitional cell carcinoma. The current study reports the case of a 61-year-old woman, who presented with gross hematuria following a radical nephrectomy for local clear cell renal carcinoma. A computed tomography scan revealed the presence of a mass on the ureteral stump. The patient underwent a left ureteral stump and bladder cuff excision. The histological diagnosis was high-grade transitional cell carcinoma of the ureteral stump, with focal interstitial cancer cell infiltrates. There was no evidence of recurrence during a follow-up period of 35 months. In addition, the present study reviewed the literature for previous patients with ureteral stump carcinoma following a radical nephrectomy for renal cell carcinoma; 7 previous patients with the disease were identified. The present study suggests that, if patients who have previously undergone a radical nephrectomy for renal cell carcinoma present with hematuria, the possibility of ureteral stump carcinoma should be considered, particularly in East Asian countries. The existence or a history of bladder carcinoma should be considered as a high-risk factor for developing ureteral stump carcinoma. A ureteral stump and bladder cuff excision should be performed once ureteral stump carcinoma is diagnosed.

Transitional Cell Carcinoma of the Renal Pelvis With Synchronous Ipsilateral Papillary Renal Cell Carcinoma: Case Report and Review

Diagnosis of synchronous primary genitourinary tumors are uncommon. Thus far, about 50 cases of synchronous renal tumors have been reported in the literature. We present for the first time a case of a 83-year-old man presenting in the same kidney two separate primary malignancies, a TCC of the renal pelvis and a papillary renal cell carcinoma Type 1. Considered the increased incidence of genitourinary tumors, in presence of a small renal tumor with hematuria, in our opinion, is necessary to pay attention to the diagnostic phase for the chance to highlight an urothelial cancer.

Renal cell carcinoma of the kidney with synchronous ipsilateral transitional cell carcinoma of the renal pelvis

A 73-year-old man was admitted to our clinic with flank pain and gross macroscopic hematuria. Radiologic examination revealed a solid mass in the left kidney and additionally another mass in the ureteropelvic junction of the same kidney with severe hydronephrosis. Left nephroureterectomy with bladder cuff removel was performed, and histopathological evolution showed a Fuhrman grade 3 clear cell type RCC with low-grade TCC of the pelvis.

Double jeopardy? Renal-sparing management of simultaneous ipsilateral renal cell carcinoma and urothelial carcinoma

The occurrence of renal cell carcinoma (RCC) and urothelial carcinoma (UC) synchronously in the same kidney is exceedingly rare. All reported cases have been managed with either nephroureterectomy or nephrectomy. We report on a patient who required renal-sparing management of his double malignancy, including open partial nephrectomy of his pT1a RCC and endoscopic laser ablation of his low-grade Ta renal pelvis UC. After 4 years, the patient is in good health and disease-free under strict surveillance. It, therefore, would appear justified to combine partial nephrectomy for RCC and endoscopic management of UC in the same kidney of an appropriately selected patient.

Synchronous renal malignancy presenting as recurrent urinary tract infections

Renal cell carcinoma (RCC) and urothelial carcinoma of the upper urinary tract are not uncommon urological malignancies. Their simultaneous occurrence in a patient is, however, extraordinarily rare. We report the case of a patient who underwent unilateral nephrectomy for suspected RCC and diagnosed transitional cell carcinoma of the superior pelvis. Preoperative imaging was suspicious for renal pelvic involvement, which was confirmed upon performing cystoscopy and biopsy of the suspected lesion preoperatively. This preoperative approach was especially appropriate as a nephron saving procedure was being considered prior to the discovery of the synchronous lesion. We discuss this rare simultaneous occurrence of synchronous malignancies in the same kidney.

Synchronous ipsilateral renal cell carcinoma and urothelial carcinoma of the renal pelvis

Renal cell carcinoma (RCC) and urothelial carcinoma of the upper urinary tract are not uncommon urological malignancies. Their simultaneous occurrence in a patient is, however, extraordinarily rare. We report the case of a patient who underwent laparoscopic nephrectomy for suspected RCC. Preoperative imaging was suspicious for renal pelvic involvement, which was confirmed upon bivalving the fresh specimen at the time of surgery, with the discovery of a separate urothelium-based lesion. We discuss this rare occurrence and our management approach.

Synchronous ipsilateral renal cell and transitional cell carcinoma

The coexistence of multiple and synchronous primary neoplasms in the genitourinary system has only rarely been described in the literature. We present the case of a 78-year-old man with haematuria as the initial presentation, finally proven to be transitional cell carcinoma (TCC) combined with renal cell carcinoma (RCC). Intravenous urography (IVU), CT and arterial angiography studies revealed a space-occupying nodule at the right upper renal pelvicalyces showing mild enhancement with contrast medium. Another strong contrast medium enhancing exophytic tumour was found at the lower pole of kidney; there were hypodense foci and calcified components in this lesion. A right nephroureterectomy was performed. Pathological diagnosis was a papillary TCC and a clear cell type RCC. This is a rare case of combined renal malignancies diagnosed by imaging.