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Saudi Journal of Kidney Diseases and Transplantation
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LETTER TO THE EDITOR Table of Contents   
Year : 2009  |  Volume : 20  |  Issue : 6  |  Page : 1081-1082
Concomitant presence of renal cell carcinoma and adenocarcinoma of the colon


Department of Urology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

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Date of Web Publication27-Oct-2009
 

How to cite this article:
Ahmadnia H, Molaei M. Concomitant presence of renal cell carcinoma and adenocarcinoma of the colon. Saudi J Kidney Dis Transpl 2009;20:1081-2

How to cite this URL:
Ahmadnia H, Molaei M. Concomitant presence of renal cell carcinoma and adenocarcinoma of the colon. Saudi J Kidney Dis Transpl [serial online] 2009 [cited 2019 Dec 9];20:1081-2. Available from: http://www.sjkdt.org/text.asp?2009/20/6/1081/57270
To the Editor,

The presence of concomitant co-existing ma­lignancies has been accepted since the report of Warren and Gates. [1] Such occurrences raise the possibility of mutations such as the Beck­with-wiedemann syndrome or certain etiologi­cal factors like alcohol and/or smoking. [2],[3] The patient's follow-up might be altered under these circumstances.

In a study done by Ray and colleagues on patients with multiple primary malignancies, genito-urinary tumors were identified in 12.5% of the patients. [4] In this study, we present a pa­tient with concomitant kidney and sigmoid malignancies.

The patient was a 68-year-old female with history of hematochezia of eight months dura­tion. A colonoscopy was performed which re­vealed a polypoid lesion located about 20 cm above the anal sphincter. Pathologic examina­tion of biopsy of the lesion, showed evidence of adenocarcinoma. The patient underwent re­section of the lesion with free margins fo­llowed by colonic anastomosis. Three months after this event, the patient presented with gross hematuria, which needed two units of blood transfusion. A CT-scan of the abdomen and pelvis with intravenous contrast was then per­formed, which demonstrated the presence of a heterogenous mass in the left kidney. The pa­tient then underwent left radical nephrectomy with probable diagnosis of metastasis. The pathology report, however, showed renal cell carcinoma (RCC) of the left kidney.

The concomitant presence of RCC with other primary malignancies including cancers of bla­dder, prostate, colorectum, lung, malignant me­lanoma (MM) of skin and non-Hodgkin's lym­phoma has been reported. [5],[6],[7],[8],[9] Rabbani et al re­ported that 209 patients out of 763 patients (27.4%) with RCC had another primary cancer, of whom, 104 cases (39.2%) were concomi­tant. Fourteen of these patients from the above­mentioned figure had concomitant colorectal cancers. [10] Beisland et al reported that 287 pa­tients out of 1425 had another primary cancer, and that 53 of them were concomitant. Of them, 25 out of 287 had colonic cancer, and 14 others had rectal cancer. [11]

Rabbani also reported that there was no sig­nificant relationship between RCC and colo­rectal cancer. [10] Although the probability of the presence of tumor in other organs was higher in patients with RCC, the incidence of colo­rectal cancers in these patients was not higher than the control group. [7],[11] Higher incidence was seen only in patients with bladder cancer. [10]

Sato and colleagues have studied survival rate in malignancies seen concomitantly with RCC. [12] According to their report, presence of other primary tumors concomitant with RCC (at the time of nepherectomy) is an independent pre­dictive factor for postoperative survival rate. Furthermore, patients with localized RCC (T 1-2) and concomitant malignancy had lower survival rate than those with localized RCC (T 1-2) only. Hemminki and Czene showed higher risk of cancer within the first year after diag­nosis and also after 10 years of diagnosis time (6%). Follow-up of RCC is usually performed for five years after surgery. [13]

Based on all these studies, we recommend that after completion of the routine follow-up course following surgery for malignancy, the patient should be examined every two years to look for evidence of any other malignancies.

 
   References Top

1.Warren S, Gates O. Multiple primary malig­nant tumors: A survey of the literature and a statistical study. Am J Cancer 1932;16:1358.  Back to cited text no. 1      
2.Schottenfeld D, Berg J. Incidence of multiple primary cancers, IV. Cancers of the female breast and genital organs. J Natl Cancer Inst 1971;46:161.  Back to cited text no. 2      
3.Ford D, Easton DF, Bishop DT, Narod SA, Goldgar DE. Risks of cancer in BRCA1-muta­tion carriers. Breast Cancer Linkage Consortium. Lancet 1994;343:692.  Back to cited text no. 3      
4.Ray P, Sharifi R, Ortolano V, Guinan P. In­volvement of the genitourinary system in mul­tiple primary malignant neoplasms: a review. J Clin Oncol 1983;1:574.  Back to cited text no. 4  [PUBMED]  [FULLTEXT]  
5.Kantor AF, McLaughlin JK, Curtis RE, Flannery JT, Fraumeni JF Jr. Risk of second malignancy after cancers of the renal paren­chyma, renal pelvis, and ureter. Cancer 1986; 58:1158-61.  Back to cited text no. 5  [PUBMED]    
6.Rabbani F, Grimaldi G, Russo P. Multiple primary malignancies in renal cell carcinoma. J Urol 1998;160:1255-9.  Back to cited text no. 6  [PUBMED]  [FULLTEXT]  
7.Czene K, Hemminki K. Kidney cancer in the Swedish Family Cancer Database: familial risks and second primary malignancies. Kidney Int 2002;61:1806-13.  Back to cited text no. 7  [PUBMED]  [FULLTEXT]  
8.Begg CB, Zhang ZF, Sun M, Herr HW, Schantz SP. Methodology for evaluating the incidence of second primary cancers with application to smoking-related cancers from the Surveillance, Epidemiology, and End Results (SEER) program. Am J Epidemiol 1995;142: 653-65.  Back to cited text no. 8  [PUBMED]  [FULLTEXT]  
9.Tihan T, Filippa DA. Coexistence of renal cell carcinoma and malignant lymphoma. A causal relationship or coincidental occurrence? Cancer 1996;77:2325-31.  Back to cited text no. 9      
10.Rabbani F, Reuter VE, Katz J, Russo P. Second primary malignancies associated with renal cell carcinoma: influence of histologic type. Urology 2000;56(3):399-403.  Back to cited text no. 10      
11.Beisland C, Talleraas O, Bakke A, Norstein J. Multiple primary malignancies in patients with renal cell carcinoma: a national population­based cohort study. BJU Int 2006;97(4):698­-702.  Back to cited text no. 11      
12.Sato S, Shinohara N, Suzuki S, Harabayashi T, Koyanagi T. Multiple primary malignancies in Japanese patients with renal cell carcinoma. Int J Urol 2004;11:269-75.  Back to cited text no. 12  [PUBMED]  [FULLTEXT]  
13.Ljungberg B, Alamdari FI, Rasmuson T, Roos G. Follow-up guidelines for nonmetastatic renal cell carcinoma based on the occurrence of metastases after radical nephrectomy. BJU Int 1999;84:405-11.  Back to cited text no. 13  [PUBMED]  [FULLTEXT]  

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Correspondence Address:
Hassan Ahmadnia
Department of Urology, Ghaem Hospital, Mashhad University of Medical Sciences Mashhad
Iran
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PMID: 19861877

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