title: Synchronous sigmoid and caecal cancers together with a primary renal cell carcinoma.
abstract: BACKGROUND
  Multiple primary neoplasms, a common clinical entity, can be classified as synchronous or metachronous. Renal cell carcinoma, in particular, is associated with a high rate of multiple primary neoplasms.
  
  
  METHODS
  We report a case of a 67-year-old Caucasian woman, who was admitted with history of bleeding per rectum. We conducted a literature review of metachronous and synchronous multiple primary neoplasms.
  
  
  RESULTS
  Colonoscopy revealed a 3 cm tumour in the caecum and a small sigmoid tubulovillous polyp. Staging computed tomography showed a non-enhancing mass in the upper pole of the right kidney. Following a radical nephrectomy/right hemicolectomy, microscopy demonstrated a renal cell carcinoma. Follow-up colonoscopy visualised a mucosal irregularity at the site of the previous sigmoid polyp, with biopsies confirming invasive adenocarcinoma. Patient underwent a total colectomy with an ileo-rectal anastamosis.
  
  
  CONCLUSIONS
  Multiple primary neoplasms are a well-recognised clinical entity. This report emphasises the need for a comprehensive evidence-based work-up in all cancer cases, especially when dealing with renal cell carcinoma, to look for coexisting metachronous/synchronous primary neoplasms.
authors.affiliation: Department of Surgery, Connolly Hospital, Blanchardstown, Dublin 15, Ireland. abhargava99@yahoo.com
authors.forename: A
authors.initials: A
authors.lastname: Bhargava
authors.forename: M
authors.initials: M
authors.lastname: O'Callaghan
authors.forename: T
authors.initials: T
authors.lastname: Abdelhafiz
authors.forename: P
authors.initials: P
authors.lastname: Downey
authors.forename: A
authors.initials: A
authors.lastname: Nasr
authors.forename: S
authors.initials: S
authors.lastname: Nibhraonain
authors.forename: C
authors.initials: C
authors.lastname: Davenport
authors.forename: M G
authors.initials: MG
authors.lastname: Donovan
authors.forename: P
authors.initials: P
authors.lastname: Keeling
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000601:surgery; D002430:Cecal Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery; D009378:Neoplasms, Multiple Primary / Q000473:pathology* / Q000601:surgery; D012811:Sigmoid Neoplasms / Q000473:pathology* / Q000601:surgery