Ann Surg Treat Res.  2015 Jun;88(6):345-348. 10.4174/astr.2015.88.6.345.

Synchronous triple primary cancers occurring in the stomach, kidney, and thyroid

• Oh SJ
• Bae DS
• Suh BJ

• KMID: 1800649
• DOI: http://doi.org/10.4174/astr.2015.88.6.345

Abstract

We report an unusual case of synchronous triple primary cancer of the stomach, kidney, and thyroid in a 50-year-old male patient. Initial esophagogastroduodenoscopy with biopsy for the medical check-up revealed poorly differentiated adenocarcinoma. We performed an abdominal/pelvic computed tomography scan for staging and incidentally found a 1.7-cm exophytic hypervascular mass in the left kidney. Thyroid ultrasonography showed suspicious malignant nodules suspicious with multiple lymph nodes (LNs) metastasis in the right side of the neck. Subsequent fine needle aspiration biopsy of a nodule and a LN was performed. Cytologic report revealed papillary thyroid carcinoma with lateral LNs metastasis. Our integrate oncology team performed radical subtotal gastrectomy, partial nephrectomy, and total thyroidectomy with modified radical neck dissection. The postoperative pathologic finding was well-differentiated gastric adenocarcinoma (T1N0M0; stage 1A), renal cell carcinoma (T1aN0M0; stage 1), and papillary thyroid carcinoma (T4bN1bM0; stage 4B). He received postoperative a radio-active iodine ablation and is doing well with no recurrence.

Keyword

Synchronous triple primary cancers; Stomach neoplasms; Renal cell carcinoma; Thyroid neoplasms

MeSH Terms

Adenocarcinoma
Biopsy
Biopsy, Fine-Needle
Carcinoma, Renal Cell
Endoscopy, Digestive System
Gastrectomy
Humans
Iodine
Kidney*
Lymph Nodes
Male
Middle Aged
Neck
Neck Dissection
Neoplasm Metastasis
Nephrectomy
Recurrence
Stomach Neoplasms
Stomach*
Thyroid Gland*
Thyroid Neoplasms
Thyroidectomy
Ultrasonography
Iodine

Figure

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  Fig. 1 Esophagogastroduodenoscopy showing early gastric cancer type IIb lesion at the lower part of the stomach.

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  Fig. 2 Abdominal/pelvic CT image showi ng no significant lymph node enlargement due to gastric cancer, but a 1.7-cm exophytic hypervascular renal mass in the inferior pole of the left kidney.

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  Fig. 3 Thyroid ultrasonography and fine needle aspiration biopsy findings: (A) A 1.6-cm irregular hypoechoic mass can be seen bulging into the superior and lateral capsule, presenting with microcalcification. (B) A 2.7-cm lobulated lymph node with internal jugular vein invasion.

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  Fig. 4 18F-fluorodeoxyglucose (8.4 mCi) PET/CT imaging find ings. A focal fluorodeoxyglucose-avid nodule with calcification in the right upper thyroid lobe (SUVmax, 3.9) can be seen. The image also shows a suspicious metastatic level III, IV, VI lymph nodes (SUVmax, 6.2) in the right side of the neck. SUVmax, standardized uptake value maximun.

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