title: A case of metachronous triple primary urogenital cancer: urinary bladder, prostate, and renal cancer.
abstract: BACKGROUND
  Multiple primary malignant tumors are rarely seen. Tobacco is one of the factors in their etiology. We report the case of a heavy smoker with metachronous triple primary cancer occurring in the prostate, kidney and urinary bladder.
  
  
  METHODS
  A 70-year-old man with prostate cancer presented with the complaint of hematuria. Computed tomography (CT) showed increased wall thickness of the urinary bladder with an enlarged prostate. After the trans-urothelial resection operation pathological diagnosis was consistent with transitional cell carcinoma of the urinary bladder. After 9 months of follow-up, the control CT showed metastatic lesions in the right and left kidneys and in the right lung. Bilateral partial nephrectomy was performed. Interestingly, renal cell carcinoma (RCC) was diagnosed. Rightsided video-assisted thoracoscopic surgery was also performed. The results of the histopathological examination were consistent with metastatic RCC.
  
  
  CONCLUSIONS
  Although the patient presented with triple carcinoma, there was no familial cancer history suggesting a genetic association. The patient was a heavy smoker, and tobacco usage may be the underlying cause of the detected cancers. This is one of the rare cases in the published literature with triple primary urogenital cancer.
authors.affiliation: Department of Internal Medicine, Sahinbey Medical Center, Gaziantep University, School of Medicine, Gaziantep, Turkey.
authors.forename: Cemile
authors.initials: C
authors.lastname: Arikan-Sengul
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Pehlivan
authors.forename: Alper
authors.initials: A
authors.lastname: Sevinc
authors.forename: Metin
authors.initials: M
authors.lastname: Karakok
authors.forename: Mehmet Emin
authors.initials: ME
authors.lastname: Kalender
authors.forename: Celalettin
authors.initials: C
authors.lastname: Camci
mesh_terms: D000368:Aged; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000601:surgery*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000601:surgery*