Laparoscopic radical resection of gastric cancer and metachronous colon cancer-a case report

Three cancers in the renal pelvis, bladder, and colon: A case report

BACKGROUND

Multiple primary cancers are rare occurrences that can involve either metachronous or synchronous development. It is particularly rare for an individual to have more than two primary cancers. In this report, we present a case study of an elderly man who was diagnosed with three heterochronous cancers in the renal pelvis, bladder, and colon.

CASE SUMMARY

On December 30, 2014, a 51-year-old Chinese man was admitted to our hospital with complaints of intermittent painless gross hematuria for the preceding week. A computed tomography (CT) scan revealed wall thickening in the left ureter's upper segment, while a CT urography revealed a left renal pelvis tumor. A successful laparoscopic radical resection of the left renal pelvis tumor was subsequently performed at Shanghai Zhongshan Hospital in January 2015. The pathological findings after the surgery revealed a low-grade papillary urothelial carcinoma of the renal pelvis. The final pathological tumor stage was pT1N0M0. After surgery, this patient received 6 cycles of intravenous chemotherapy with gemcitabine and carboplatin, as well as bladder infusion therapy with gemcitabine. On December 18, 2017, the patient was admitted once again to our hospital with a one-day history of painless gross hematuria. A CT scan showed the presence of a space-occupying lesion on the posterior wall of bladder. Cystoscopic examination revealed multiple tumors in the bladder and right cutaneous ureterostomy was performed under general anesthesia on December 29, 2017. The postoperative pathological findings disclosed multifocal papillary urothelial carcinoma of the bladder (maximum size 3.7 cm × 2.6 cm). The bladder cancer was considered a metastasis of the renal pelvis cancer after surgery. The pathological tumor stage was pT1N0M1. The patient refused chemotherapy after surgery. After another six years, the patient returned on February 28, 2023, complaining of periumbilical pain that had lasted six days. This time, a CT scan of the abdomen showed a tumor in the ascending colon, but a subsequent colonoscopy examination indicated a tumor in the descending colon. On March 12, 2023, a subtotal colectomy and an ileosigmoidal anastomosis were carried out under general anesthesia. Postoperative pathological findings revealed that all three tumors were adenocarcinomas. The final pathological tumor stage was pT3N0M0. The patient had an uneventful postoperative recovery and was discharged without complications.

CONCLUSION

The case of this elderly man presents a rare occurrence of metachronous primary cancers in the renal pelvis and colon. Bladder cancer is considered a metastasis of renal pelvis cancer after surgery. Optimal treatment can be implemented by evaluating the patient's histological features, clinical history, and tumor distribution correctly.

Application of radiomics in precision prediction of diagnosis and treatment of gastric cancer

Gastric cancer is one of the most common malignant tumors. Although some progress has been made in chemotherapy and surgery, it is still one of the highest mortalities in the world. Therefore, early detection, diagnosis and treatment are very important to improve the prognosis of patients. In recent years, with the proposal of the concept of radiomics, it has been gradually applied to histopathological grading, differential diagnosis, therapeutic efficacy and prognosis evaluation of gastric cancer, whose advantage is to comprehensively quantify the tumor phenotype using a large number of quantitative image features, so as to predict and diagnose the lesion area of gastric cancer early. The purpose of this review is to evaluate the research status and progress of radiomics in gastric cancer, and reviewed the workflow and clinical application of radiomics. The 27 original studies on the application of radiomics in gastric cancer were included from web of science database search results from 2017 to 2021, the number of patients included ranged from 30 to 1680, and the models used were based on the combination of radiomics signature and clinical factors. Most of these studies showed positive results, the median radiomics quality score (RQS) for all studies was 36.1%, and the development prospect and challenges of radiomics development were prospected. In general, radiomics has great potential in improving the early prediction and diagnosis of gastric cancer, and provides an unprecedented opportunity for clinical practice to improve the decision support of gastric cancer treatment at a low cost.