SYNCHRONOUS COLORECTAL AND RENAL TUMORS: A RARE ASSOCIATION

Case Presentation: Woman, 49 years old, obese, hypertensive, complained of low back pain in right renal topography for 3 months, showing a solid lesion to the images and indicated radical nephrectomy. She returns to the hospital with abdominal pain for 1 week, located in right upper quadrant, in colic, associated with abdominal distension, nausea and vomit. On physical examination, palpable mass on the right flank, fibroelastic consistency, approximately 6cm in length, with no signs of peritonitis. Finding of obstructive lesion in hepatic flexure of the colon, insurmountable to colonoscopy. Directed to the surgical treatment and performed right hemicolectomy and right radical nephrectomy. Discussion: Tumors are said to be synchronic when they present simultaneously with the diagnosis, with a maximum interval of 6 months, ruling out the possibility of contiguity lesions (metastasis, invasion or recurrence of the first), as well as malignant and distinct histological types. Colorectal cancer is the most common of the gastrointestinal tract, with adenocarcinoma being the most frequent histopathological type, usually associated with hereditary syndromes. Signs and symptoms of alertness should be valued. Renal cell carcinoma comprises 1 to 3% of visceral neoplasms, being the most lethal of urological cancers; the most common histologic subtype is clear cell carcinoma. Renal lesions are usually asymptomatic and impalpable until the more advanced stages of the disease, in addition to being diagnosed, in most cases, incidentally. Final considerations:Despite the high prevalence of both neoplasms individually, the concomitance of primary tumors developing in the colon and kidney is rarely described. It has a poorly defined cause and is quite complex, multifactorial. The main treatment is R0 surgical resection. The prognosis of the disease, in general, depends on the staging, the cell type, the cell differentiation and the surgeon factor (R0 surgery capacity). The uncommon association of these neoplasms reaffirms the need for early access to the specialized team, able to investigate and treat patients with diverse neoplasms quickly and efficiently.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
23 October 2019