Asian Journal of Case Reports in Surgery

Laparoscopic Curative Resection of Synchronous Primary Colon Adenocarcinoma and Renal Cell Carcinoma: A Case Report

Sze Li Siow *

Department of General Surgery, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Malaysia and Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Kuching, Malaysia.

Wai Tseung Soo

Department of General Surgery, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Malaysia.

Guan Chou Teh

Department of Urology, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Malaysia.

Noraini Mohamad

Department of Pathology, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Malaysia.

Myo Nyunt

Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Kuching, Malaysia.

*Author to whom correspondence should be addressed.

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Abstract

Introduction: Synchronous colorectal and renal carcinomas are rare entity, with a reported incidence of 0.4 to 4.85%. Both are primary cancers occurring in the same patient, either at the same time or within 6 months apart.

Presentation of Case: We report a case of a 61-year-old man who presented with 3 months history of left lower abdominal pain and painless per rectal bleeding. Colonoscopy revealed a fungating mass 20 cm from the anal verge and histopathological examination of the biopsies confirmed a moderately differentiated adenocarcinoma. Computed tomography scan of abdomen showed a thickened sigmoid colon with enlarged pericolic lymph nodes and an incidental finding of a left renal upper pole mass. He underwent laparoscopic left partial nephrectomy and laparoscopic anterior resection in the same setting. Histopathological examination revealed moderately differentiated adenocarcinoma of sigmoid colon and a clear cell renal cell carcinoma with good margins of resection. He recovered well, completed adjuvant chemotherapy and remained recurrence free at his 1-year follow-up.

Conclusions: Simultaneous laparoscopic surgery for synchronous colorectal and renal carcinomas offers the advantages of primary tumour resection within the same setting & is technically feasible and safe. When attempting surgery for tumours involving left hemicolon and left kidney, a combined approach where nephrectomy followed by colonic resection should be the surgical strategy.

Keywords: Synchronous tumours, colorectal carcinoma, renal carcinoma

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