MULTIDISCIPLINARY APPROACH FOR PRIMARY MULTIPLE SYNCHRONOUS CANCER. CLINICAL CASE
Abstract
Primary multiple malignancies are rarely observed in clinical practice. Literature data indicate the existence of potential risk factors, primarily genetic ones (Li-Fraumeni or Beckwith–Wiedemann syndromes) for the development of such diseases. Most of the tumors found in various organs are metachronous. This paper presents a variant of managing a patient with primary multiple neoplasia of the kidney, prostate, and colon. The patient (61 years old) was admitted to clinic with diagnosis: primary multiple metachronous cancer: left kidney cancer cT3aN0M0, prostate cancer cT1bN0M0, neoplasm of the right colon (tubular adenoma with high-grade dysplasia). Comorbidities: coronary heart disease, paroxysmal form of atrial fibrillation, arterial hypertension. The clinic held a multidisciplinary consultation involving an oncologist, a coloproctologist, an urologist, a radiologist, a chemotherapist, an anesthesiologist, a cardiologist, and a rehabilitation specialist. Simultaneous laparoscopic prostatectomy, nephrectomy, and right hemicolectomy were performed. The patient was managed according to the standard protocols of the "rapid recovery" program.
Distinctive feature of the patient we observed was that the kidney tumor was detected 8 years ago during an outpatient examination, although we could not confirm this fact documented. Since the association between renal cell carcinoma and the risk of developing other malignant tumors has been shown in the literature, we can assume with high probability that patients with renal cell carcinoma have an increased risk of developing a subsequent primary malignancy.
About the Authors
E. A. GalliamovRussian Federation
Galliamov Eduard Abdulhaevich – MD, Professor, Head of the General Surgery Department
Bolshaya Pirogovskaya St., 19/1, 119146, Moscow
M. A. Agapov
Russian Federation
Agapov Mihail Andreevich – MD, Professor of the Department of Surgery
Leninskie Gory St., 1, 119991, Moscow
V. A. Kubishkin
Russian Federation
Kubishkin Valery Alekseevich - MD, academician of RSA, Head of the Department of Surgery
Leninskie Gory St., 1, 119991, Moscow
R. G. Biktimirov
Russian Federation
Biktimirov Rafael Gabbasovich – PhD, head of the Department of Urology
district Novogorsk, Himkinskij city district, 141435
P. S. Malahov
Russian Federation
Malahov Pavel Sergeevich - head of the Department of intensive care and anesthesiology of medical research and education center
Leninskie Gory St., 1, 119991, Moscow
V. V. Kakotkin
Russian Federation
Kakotkin Viktor Viktorovich - Resident of the Department of Surgery of the Faculty of Medicine
Leninskie Gory St., 1, 119991, Moscow
References
1. Rabbani F, Grimaldi G, Russo P. Multiple primary malignancies in renal cell carcinoma. J Urol. 1998; 160:1255-1259. https://doi.org/10.1016/ S0022-5347(01)62510-2
2. Moertel CG. Multiple primary malignant neoplasms: Historical perspectives. Cancer. 1977; 40(suppl):1786-1792. https://doi.org/10.1002/10970142(197710)40:4+<1786::AIDCNCR2820400803>3.0.CO;2-2
3. Howe HL. A Review of the Definition for Multiple Primary Cancers in the United States; Workshop Proceedings From December 4—6, 2002; Princeton, New Jersey. 2003. 46 p.
4. AIRTUM Working Group1. Italian cancer figures, report 2013: Multiple tumours. Epidemiol Prev. 2013; 37(4-5 suppl 1):1-152.
5. Ray P, Sharifi R, Ortolano V, Guinan P. Involvement of the genitourinary system in multiple primary malignant neoplasms: A review. J Clin Oncol. 1983; 1:574-581.
6. Beisland C, Talleraas O, Bakke A, Norstein J. Multiple primary malignancies in patients with renal cell carcinoma: A national populationbased cohort study. BJU Int. 2006; 97:698-702. https://doi.org/10.1111/j.1464-410X.2006.06004.x
7. Demandante CG, Troyer DA, Miles TP. Multiple primary malignant neoplasms: Case report and a comprehensive review of the literature. Am J Clin Oncol. 2003; 26:79-83. https://doi.org/10.1097/00000421200302000-00015
8. Warren S, Gates O. Multiple primary malignant tumors: A survey of the literature and a statistical study. Am J Cancer. 1932; 16:1358-1414.
9. Heidenreich A, Bastian PJ, Bellmunt J, Bolla M, Joniau S, van der Kwast T et al. EAU guidelines on prostate cancer. Part 1 Screening, diagnosis, and local treatment with curative intent — update 2013. Eur Urol. 2014; 65:124-137. https://doi.org/10.1016/j.eururo.2013.09.046
10. Pushkar D.Ju., Bormotin A.V., Govorov A.V. The algorithm of early diagnostics of prostate cancer. Russian Medical Journal. 2003; 8:4831. [In Russ]
11. International Agency for Research on Cancer. The GLOBOCAN project: cancer incidence and mortality worldwide in 2014.
12. Kaprin AD, Starinski VV. The state of oncological medical cervices for Russian population in 2016. P.A. Gertsen MSROI — the filial of FSBI NMRCR of the Ministry of Health of Russia Federation. M. 2017. 236 p. [In Russ]
13. Kashin S.V. Modern aspects of colonoscopy, with the aim of screening for polyps and colorectal cancer. Dokazatel’naja gastrojenterologija. 2014; 3:57-67. [In Russ]
14. Luciani A, Balducci L. Multiple primary malignancies. Semin Oncol. 2004; 31:264-273. https://doi.org/10.1053/j.seminoncol.2003.12.035
15. Pastore AL, Palleschi G, Autieri D, Leto A, Ripoli A, Maggioni C et al. Synchronous primary neoplasms of the bladder, skin and breast in a male patient: A case report. World J Surg Oncol. 2013; 11:282. https://doi.org/10.1186/1477-7819-11-282
16. Pastore AL, Palleschi G, Tubaro A, De Nunzio C, Stoppaciaro A, Silvestri L et al. Synchronous urinary tract metastases from breast cancer. Urologia. 2009; 76:66-67.
Review
For citations:
Galliamov E.A., Agapov M.A., Kubishkin V.A., Biktimirov R.G., Malahov P.S., Kakotkin V.V. MULTIDISCIPLINARY APPROACH FOR PRIMARY MULTIPLE SYNCHRONOUS CANCER. CLINICAL CASE. Surgical practice (Russia). 2019;(4):62-67.
Email this article 