Department of Surgery, Connolly Hospital, Blanchardstown, Dublin 15, Ireland.
Ir J Med Sci. 2012 Jun;181(2):273-6. doi: 10.1007/s11845-009-0298-4. Epub 2009 Mar 13.
Multiple primary neoplasms, a common clinical entity, can be classified as synchronous or metachronous. Renal cell carcinoma, in particular, is associated with a high rate of multiple primary neoplasms.
We report a case of a 67-year-old Caucasian woman, who was admitted with history of bleeding per rectum. We conducted a literature review of metachronous and synchronous multiple primary neoplasms.
Colonoscopy revealed a 3 cm tumour in the caecum and a small sigmoid tubulovillous polyp. Staging computed tomography showed a non-enhancing mass in the upper pole of the right kidney. Following a radical nephrectomy/right hemicolectomy, microscopy demonstrated a renal cell carcinoma. Follow-up colonoscopy visualised a mucosal irregularity at the site of the previous sigmoid polyp, with biopsies confirming invasive adenocarcinoma. Patient underwent a total colectomy with an ileo-rectal anastamosis.
Multiple primary neoplasms are a well-recognised clinical entity. This report emphasises the need for a comprehensive evidence-based work-up in all cancer cases, especially when dealing with renal cell carcinoma, to look for coexisting metachronous/synchronous primary neoplasms.
多原发肿瘤是一种常见的临床实体，可以分为同时性或异时性。肾细胞癌尤其与多原发肿瘤的高发生率相关。
我们报告了一例 67 岁白人女性，因直肠出血入院。我们对异时性和同时性多原发肿瘤进行了文献复习。
结肠镜检查显示盲肠有 3 厘米大的肿瘤和乙状结肠小的管状绒毛状息肉。分期 CT 显示右肾上极有一个不增强的肿块。行根治性肾切除术/右半结肠切除术，显微镜下显示肾细胞癌。随后的结肠镜检查显示先前乙状结肠息肉部位有黏膜不规则，活检证实为浸润性腺癌。患者行全结肠切除术和回直肠吻合术。
多原发肿瘤是一种公认的临床实体。本报告强调了在所有癌症病例中进行全面的基于证据的检查的必要性，特别是在处理肾细胞癌时，需要寻找同时性或异时性并存的原发性肿瘤。
