title: Coexistence of a colon carcinoma with two distinct renal cell carcinomas: a case report.
abstract: BACKGROUND
  We present the case of a patient with two tumors in his left kidney and a synchronous colon cancer. While coexisting tumors have been previously described in the same kidney or the kidney and other organs, or the colon and other organs, to the best of our knowledge no such concurrency of three primary tumors has been reported in the literature to date.
  
  
  METHODS
  A 72-year-old man of Greek nationality presenting with pain in the right hypochondrium underwent a series of examinations that revealed gallstones, a tumor in the hepatic flexure of the colon and an additional tumor in the upper pole of the left kidney. He was subjected to a right hemicolectomy, left nephrectomy and cholecystectomy, and his postoperative course was uneventful. Histopathology examinations showed a mucinous colon adenocarcinoma, plus two tumors in the left kidney, a papillary renal cell carcinoma and a chromophobe renal cell carcinoma.
  
  
  CONCLUSIONS
  This case underlines the need to routinely scan patients pre-operatively in order to exclude coexisting tumors, especially asymptomatic renal tumors in patients with colorectal cancer, and additionally to screen concurrent tumors genetically in order to detect putative common genetic alterations.
authors.affiliation: First Department of Surgery, University of Athens, Laiko General Hospital, Greece. lefman@gmail.com.
authors.forename: Alexandros E
authors.initials: AE
authors.lastname: Papalampros
authors.forename: Athanasios S
authors.initials: AS
authors.lastname: Petrou
authors.forename: Eleftherios I
authors.initials: EI
authors.lastname: Mantonakis
authors.forename: Konstantinos I
authors.initials: KI
authors.lastname: Evangelou
authors.forename: Lambros A
authors.initials: LA
authors.lastname: Giannopoulos
authors.forename: Georgios G
authors.initials: GG
authors.lastname: Marinos
authors.forename: Athanasios L
authors.initials: AL
authors.lastname: Giannopoulos