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- Title
Triple Threat: Three Primary Malignancies Simultaneously Involving Three Genitourinary Organs.
- Authors
Mitchell, Katharina; El Naili, Reima; Pillai, Lakshmikumar; Lopez, Eric Mark; Riordan, John; Marsh, Wallis; Luchey, Adam; Hajiran, Ali
- Abstract
Statistically, the chance of having concurrent renal cell carcinoma (RCC), urothelial carcinoma of the bladder (UC), and a neuroendocrine tumor (NET) of the renal parenchyma is less than one in a trillion. Herein, we describe an unusual case of a 67-year-old female who presented with bilateral flank pain and severe gross hematuria. Cross-sectional imaging revealed two large heterogeneous, endophytic renal masses with a single enlarged paracaval lymph node. Diagnostic cystoscopy was performed for completion of gross hematuria evaluation and revealed a concurrent papillary bladder tumor. Percutaneous biopsies of bilateral renal masses revealed clear cell RCC involving the left kidney and well-differentiated NET involving the right kidney, and transurethral resection of the bladder tumor revealed high-grade nonmuscle invasive urothelial carcinoma. The patient elected to undergo bilateral nephroureterectomy, radical cystectomy, and retroperitoneal and pelvic lymphadenectomy. Final pathology confirmed the presence of three different malignancies: noninvasive high-grade papillary UC of the bladder (pTaN0), left renal clear cell RCC (pT2bN0), right renal well-differentiated NET, and a single paracaval lymph nodes positive for metastatic NET (pT2aN1).
- Subjects
GENITOURINARY organs; BLADDER cancer; RENAL cell carcinoma; TRANSURETHRAL resection of bladder; TRANSITIONAL cell carcinoma; CROSS-sectional imaging; LYMPH nodes
- Publication
Case Reports in Urology, 2023, p1
- ISSN
2090-696X
- Publication type
Case Study
- DOI
10.1155/2023/3242986