Surgical Treatment of Synchronous Colorectal and Renal Neoplasms

Abstract

Background: Synchronous tumors are rare clinical entity. In most cases, they are found accidentally in the process of primary tumor staging. The detection rate of synchronous blastomas has increased over the past decades due to the advance and more frequent use of imaging modalities. Only a few cases of colorectal carcinoma (CRC) and concurrent incidental renal tumors have been reported in recent years, with their incidence rates varying as reported by different authors (0.043-4.85%). Methods: We performed retrospective analysis of our database for patients, admitted for elective colonic resection for CRC, who had adequate preoperative staging (abdominal CT or MRI), and presented with simultaneous renal tumors. Between 2009 and 2018 we identified 1472 cases of CRC. Of them 1345 underwent radical surgery, preoperative imaging was available for 1117 patients (83%), among whom 4 were diagnosed with synchronous neoplasms (0.35%). Results: The average age in our group was 52.5 years (43-63), with male/female ratio of 1:1. CRC was the initial diagnosis, and renal tumors were accidentally detected by CT scan in the staging process. Three of the patients had combination of rectal and left kidney cancer, and one had ascending colon cancer and right kidney cancer. All 4 patients underwent simultaneous removal of both tumors: two patients underwent open and two laparoscopic procedures. Conclusions: Although rare, synchronous colorectal and renal tumors may be encountered, mainly thanks to preoperative diagnostic imaging. Performing simultaneous resection is safe and is not associated with increased complication rate. The laparoscopic approach is a viable option, when performed by an experienced team.