Baddoura Mouna, Idelbi Ahmad, Salman Reem, Al-Mahasna Souheb
Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic.
Department of General Surgery, Al-Mouwasat University Hospital, Damascus, Syrian Arab Republic.
Ann Med Surg (Lond). 2025 Apr 10;87(6):3853-3857. doi: 10.1097/MS9.0000000000003214. eCollection 2025 Jun.
Multiple primary malignancies (MPMs) are separate malignant tumors in the same patient that are not caused by metastasis or recurrence; they represent between 1.84% and 3.9% of all malignancies. Synchronous MPMs, where the tumors are detected at the same time, are even rarer, with a rate of about 0.7%. Moreover, synchronous primary neoplasms involving both the kidneys and ovaries are extremely rare and have been reported in only a few cases in medical literature.
We present the first case to be reported in Syria as multiple primary tumors of a 62-year-old woman who presented with heaviness in her lower abdomen and right hypochondrium and was found to have synchronous primary tumors, left renal clear cell carcinoma and right ovarian papillary serous cystadenocarcinoma based on computed tomography-scan and histopathology. The patient underwent left radical nephrectomy and resection of the right ovary and will receive adjuvant chemotherapy, with regular follow-up recommended to monitor for any signs of recurrence or metastasis.
Based on our literature review, the co-occurrence of ovarian tumor with renal cell carcinoma is uncommon. Distinguishing between metastatic tumors and simultaneous primary tumors presents a significant diagnostic challenge. Achieving a precise diagnosis requires the observation of markedly different histologies to confirm the presence of concurrent primary tumors.
This case serves as a reminder that when a patient presents with multiple masses, it is important to consider the possibility that they could be separate primary tumors despite their rarity.
多原发性恶性肿瘤(MPMs)是指同一患者体内的多个独立恶性肿瘤,并非由转移或复发引起;它们占所有恶性肿瘤的1.84%至3.9%。同时性MPMs,即肿瘤在同一时间被检测到,更为罕见,发生率约为0.7%。此外,同时累及肾脏和卵巢的原发性肿瘤极为罕见,医学文献中仅报道了少数病例。
我们报告叙利亚首例病例,一名62岁女性患有多原发性肿瘤,表现为下腹部和右季肋部沉重感,经计算机断层扫描和组织病理学检查发现为同时性原发性肿瘤,即左肾透明细胞癌和右卵巢乳头状浆液性囊腺癌。患者接受了左肾根治性切除术和右卵巢切除术,并将接受辅助化疗,建议定期随访以监测复发或转移的任何迹象。
根据我们的文献综述,卵巢肿瘤与肾细胞癌同时发生并不常见。区分转移性肿瘤和同时性原发性肿瘤是一项重大的诊断挑战。要实现精确诊断,需要观察明显不同的组织学特征以确认同时存在原发性肿瘤。
该病例提醒我们,当患者出现多个肿块时,尽管其罕见,但重要的是要考虑它们可能是独立原发性肿瘤的可能性。