Synchronous colonic adenocarcinoma and renal oncocytoma: a case report and literature review

Renal Oncocytoma and Pelvic Urothelial Carcinoma in a Nephrectomy Specimen of a 72-Year-Old Patient

We present the case of a 72-year-old gentleman who presented with a left renal mass. His Computerized Tomography Angiogram showed an 11.8 x 11.3 cm mass involving the upper pole of the left kidney. The mass showed a central stellate scar. There was no locoregional lymphadenopathy. His radical nephrectomy specimen was received in our lab. Sectioning showed a large tumor in the upper pole with a central stellate scar. Microscopically, it showed sheets and nests of round cells with eosinophilic cytoplasm and round nuclei. It was positive for CD117 and negative for CK7. The sections from the renal pelvis showed a urothelial carcinoma arising from the urothelial lining and infiltrating the muscular wall of the renal pelvis. This tumor was positive for CK7 and GATA3. In this case report, we present a rare collision tumor of renal oncocytoma and pelvic urothelial carcinoma.

Simultaneous totally robotic rectal resection and partial nephrectomy: case report and review of literature

Introduction

The incidence of synchronous RCC and colorectal cancer is heterogeneous ranging from 0.03 to 4.85%. Instead, only one case of huge colon carcinoma and renal angiomyolipoma was reported. The treatment of synchronous kidney and colorectal neoplasm is, preferably, synchronous resection. Currently, laparoscopic approach has shown to be feasible and safe, and it has become the gold standard of synchronous resection due to advantages of minimally invasive surgery. We presented a case synchronous renal neoplasm and colorectal cancer undergone simultaneous totally robotic renal enucleation and rectal resection with primary intracorporeal anastomosis. As our knowledge, this is the first case in literature of simultaneous robotic surgery for renal and colorectal tumor.

Case presentation

A 53-year-old woman was affected by recto-sigmoid junction cancer and a solid 5 cm left renal mass. We performed a simultaneous robotic low anterior rectal resection and renal enucleation. Total operative time was 260 min with robotic time of 220 min; estimated blood loss was 150 ml; time to flatus was 72 h, and oral diet was administered 4 days after surgery. The patient was discharged on the eighth post-operative day without peri- and post-operative complication. The definitive histological examination showed a neuroendocrine tumor pT2N1 G2, with negative circumferential and distal resection margins. Renal tumor was angiomyolipoma. At 23 months follow-up, the patient is recurrence free.

Discussion and conclusion

As our knowledge, we described the first case in literature of simultaneous robotic anterior rectal resection and partial nephrectomy for treatment of colorectal tumor and renal mass. Robotic rectal resection with intracorporeal anastomosis surgery seems to be feasible and safe even when it is associated with simultaneous partial nephrectomy. Many features of robotic technology could be useful in combined surgery. This strategy is recommended only when patients’ medical conditions allow for longer anesthesia exposure. The advantages are to avoid a delay treatment of second tumor, to reduce the time to start the post-operative adjuvant chemotherapy, to avoid a second anesthetic procedure, and to reduce the patient discomfort. However, further studies are needed to evaluate robotic approach as standard surgical strategy for simultaneous treatment of colorectal and renal neoplasm.

[Colon adenocarcinoma and synchronous type 1 papillary renal cell carcinoma: a unique association]

La découverte de tumeurs primitives synchrones à un cancer colorectal a fait l’objet de plusieurs publications. Cette association peut survenir de manière sporadique ou rentrer dans le cadre de syndromes cliniques bien définis tel que le syndrome de Lynch. L’association synchrone d’un cancer colorectal (CCR) et d’un carcinome à cellules rénales est rare. Elle est encore plus rare lorsque le carcinome à cellules rénales est de sous-type papillaire avec seulement 2 cas rapportés dans la littérature. L’association CCR et rénaux ne semble pas être liée à une anomalie des protéines du système MMR (MisMatch Repair) et n’intègre à ce jour aucun syndrome clinique. Nous rapportons le cas d’une femme âgée de 69 ans qui a simultanément présenté un adénocarcinome colique et un carcinome papillaire du rein de type 1, de découverte fortuite au cours du bilan d’extension du CCR. Nous discuterons la pathogénie ainsi que le pronostic de cette entité rarement décrite.