Synchronous papillary endometrial and ovarian cancer in a 64-year-old woman

Obesity, nulliparity, and comparatively younger age may attribute a “hormonal field effect” which leads to the development of synchronous endometrioid cancers. The morphological unit consisting of the uterus, fallopian tubes, and ovary as part of the Mullerian system may explain the synchronous appearance of these malignancies. Synchronous endometrial and ovarian cancer (SEOC) is defined as the simultaneous presence of these dual cancers at the time of diagnosis as opposed to metachronous cancer where these two cancers are diagnosed at different chronologic time points. Synchronous malignancies in the female genital tract are very rare entities. Synchronous endometrial and ovarian tumors must be differentiated from either primary endometrium or ovarian tumors with metastasis. The landmark criteria for diagnosing such cases have been laid down by Ulbright and Roth.

Primary synchronous malignancies of the breast and the kidney

Synchronous primary malignancies are most frequently seen with cancers of the stomach and oesophagus, mainly attributed to the similar genetic mutations. Most of these multiple malignancies turn out to be metastatic or metachronous lesions. Multiple synchronous malignancies are rarer than metachronous ones. Primary synchronous breast and renal cancer is even rare. These patients require extensive workup to exclude all possible metastases. The nature of the primary tumours must also be confirmed, prior to any treatment strategy. We report the case of a healthy, middle-aged woman who initially presented with a lesion suspicious for breast carcinoma, and further workup revealed the presence of an asymptomatic, synchronous primary renal cell cancer, which is a very rare presentation.

A Rare Case of Synchronous Ovarian Adenocarcinoma and Squamous Cell Carcinoma of Cervix

Synchronous tumours of gynaecological malignancies occur rarely and most of these cases are represented by synchronous ovarian and endometrial cancer. Synchronous malignancies of cervix and ovary are rare with poor prognosis. Only few cases of synchronous cancer of cervix and ovary are found in the literature as case reports. Here, we report a case of a 63 year old patient who was diagnosed with synchronous squamous cell carcinoma of cervix and high grade serous carcinoma of ovary in which her clinical presentation, investigation and intraoperative findings were atypical. Patient presented with postmenopausal bleeding and mass per abdomen. Pipelle sampling revealed squamous cell carcinoma of cervix. Examination under anaesthesia noted endocervical growth measuring 3×4 cm with endoluminal extension into the whole endometrial cavity. Computerized tomography (CT) imaging showed left ovarian mass measuring 10.0×11.7 cm. Uterine corpus involvement in this case mislead us to the initial diagnosis of ovarian metastasis in cervical cancer. The distinct histopathological features of the ovary, cervix and endometrial lesion post operatively helped in establishing the diagnosis of two separate primaries which was synchronous cervical and ovarian cancer rather than metastatic spread of one primary malignancy.

Diagnostic and therapeutic challenges of synchronous renal mass and pancreatic mass: a review

Objective: Synchronous renal cell carcinoma (RCC) and pancreatic tumors are rare clinical events and have been described scarcely in the literature. Our institution has recently encountered one case. This review aims to summarize and present the diagnostic and therapeutic approaches that have been presented in the literature for these synchronous solid malignancies. Methods: After reviewing the literature using PubMed, 16 papers were collected that showed a total of 21 patients with a synchronous solid renal and pancreatic mass. The diagnostic and treatment data were then evaluated and analyzed. Results: Overall, 13 patients (59%) had two independent primary malignancies consisting of RCC and a pancreatic tumor, seven (31%) were diagnosed with primary RCC with synchronous metastasis to pancreas, one (5%) was found to have a primary pancreatic adenocarcinoma with synchronous metastasis to the kidney, and one (5%) was diagnosed with primary RCC with a benign solid pancreatic lesion. Of the 22 patients that were treated, 18 (81%) underwent surgery, one (5%) had no treatment, and three (14%) underwent chemotherapy without surgery. In the cohort of patients with surgical treatment 12 (66%) had no adjuvant therapy, one (6%) had adjuvant chemotherapy, four (22%) had adjuvant immunotherapy, and one (6%) had adjuvant radiation treatment. Conclusions: The occurrence of synchronous malignancies of the kidney and pancreas is rare. No clear guidelines have evolved in the literature in regard to diagnostics and treatment of these patients. This review presents recommended diagnostic and treatment guidelines for these rare clinical cases. Level of evidence: Not applicable for this multicenter review.

Value of oesophagoscopy and bronchoscopy in diagnosis of synchronous malignancies in patients with head and neck squamous cell carcinomas

Background Routine screening of patients with head and neck squamous cell carcinomas (HNSCCs) for synchronous malignancies using oesophagoscopy and bronchoscopy had been controversial. The aim of this study is therefore to find out the rate of synchronous malignancies in patients with primary HNSCCs, the risk factors for its occurrence and the effectiveness of oesophagoscopy and bronchoscopy from a 10-year experience in a single centre. Methods A retrospective review of medical records was conducted from July 2008 to June 2018 in a tertiary referral centre in Hong Kong. All patients with newly diagnosed HNSCCs were screened with oesophagoscopy and bronchoscopy at the time of diagnosis and therefore all patients were included in the study. The incidence of synchronous malignancies along the aerodigestive tract and the yield of oesophagoscopy and bronchoscopy were studied. Results Of the 702 patients included in the study, the overall rate of synchronous malignancies was 8.3% (58/702), with the rate of synchronous oesophageal and lung malignancies being 5.8% (41/702) and 0.85% (6/702) respectively. Fourteen out of the 41 oesophageal malignancies were only detectable with oesophagoscopy. Only one of the synchronous lung malignancies was detectable by bronchoscopy. Risk factors for synchronous malignancies include male gender, smokers, drinkers and primary hypopharyngeal cancer. Conclusions Oesophagoscopy is essential for detecting synchronous oesophageal malignancies in patients with HNSCCs especially in male patients, smokers and drinkers, and it is most valuable in primary hypopharyngeal cancer patients among all primary subsites. Bronchoscopy had a low yield for synchronous lung malignancies and can be potentially replaced by imaging techniques.

CARCINOMA PROSTATE WITH CARCINOMA PENIS: RARE CASE OF DUAL PRIMARY UROLOGICAL MALIGNANCY

Synchronous malignancies are an uncommon finding in urology. A penile lesion in a patient of carcinoma prostate is an uncommon is generally a metastasis with incidence of <0.1%. Here we present a case of synchronous primary urological malignancies of squamous cell carcinoma of penis and adenocarcinoma prostate. Synchronous malignancies should be considered on an individual basis and therapeutic choice should aim to provide minimal possible morbidity with maximum efficacy without compromising oncological outcomes.

Adenocarcinoma of the Gastroesophageal Junction with Synchronous Renal Cell Carcinoma: A Case Report and Literature Review

Gastroesophageal junction adenocarcinoma is a rare type of cancer of the esophagus. It is usually diagnosed in advanced stages and much less frequently in the earlier stage, where surgical treatment is essential. Surgical treatment is also essential in kidney cancer. The occurrence of synchronous malignancies with an esophageal malignancy is a well-described phenomenon with an incidence ranging from 3.6 to 27.1%. To the best of our knowledge, only 11 cases of synchronous esophageal and renal cell carcinoma (RCC) have been previously described. We present a patient operated simultaneously for cancer of the gastroesophageal junction with synchronous renal cell carcinoma. The finding in the kidney was accidentally discovered by the routine CT scan on the occasion of the relatively early carcinoma of the gastroesophageal junction detected by upper endoscopy. The patient was admitted to the Thoracic Surgery Department, where Ivor-Lewis gastroesophagoplasty and right nephrectomy simultaneously were performed. The patient was followed for 5 years without evidence of disease progression.