Synchronous Carcinoma Cervix With Renal Cell Carcinoma: An Incidental Finding

Volume 9, Issue 6, June – 2024 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165 https://doi.org/10.38124/ijisrt/IJISRT24JUN536
Synchronous Carcinoma Cervix with

Renal Cell Carcinoma: An Incidental Finding
Dr. Mayank Soni1, Dr. Shrutikant Bhatia1, Dr. Dhiraj Gupta1
1
Junior Resident, Department of Radiation Oncology, All India Institue of Medical Sciences, Rishikesh – 249002,
Abstract:- RCC often coexists with malignancies in the prostate,

bladder, lung, breast, rectum, malignant melanoma, and non-
 Background Hodgkin lymphoma (NHL), its association with other pelvic
In India, renal cell carcinoma (RCC) is the most tumours, such as carcinoma cervix, is rare. (4)
frequent kidney cancer with an increasing tendency,
whereas cervical cancer is the second most common In this case, RCC was found incidentally during staging
disease among women. Synchronicity of RCC with other and evaluation of the primary cervical carcinoma and both
malignancies is not uncommon, but with the cervical were managed with different modality of treatment. So
cancer is rare. diagnostic imaging should be included in standard of care for
pelvic malignancies and surveyed the other regions as well.
 Case description
A 64-year-old, postmenopausal female, presented II. CASE DESCRIPTION
with complaint of bleeding per vagina and was diagnosed
with carcinoma cervix and later on metastatic work-up 64 year old, postmenopausal female presented to us
also diagnosed with right RCC. After multidisciplinary with complaint of bleeding per vagina since three months. On
discussion, patient planned for management for cervix clinical examination, there was 4 x 4 cm ulceroproliferative
then followed by renal lesion. Patient received radical growth present on the cervical os, obliterating the all the
external beam radiotherapy followed by brachytherapy fornices, limited to upper one-third of vagina and bilateral
for carcinoma cervix and underwent nephrectomy for parametrium was free of disease. Punch biopsy was
right RCC. consistent with the squamous cell carcinoma.
 Conclusion Contrast enhanced MRI of pelvis was suggestive of

Synchronous cases of cervical cancer and renal cell heterogeneously enhancing lobulated mass lesion (5 x 3.5 x
carcinoma are very rare. Advancement in diagnostic 3.2cm) in the region of cervix extending to the body of uterus
protocol makes these kind of cases common and superiorly and inferiorly involving the fornices. For metstatic
multidisciplinary team decisions are required for their work up, PET-CT scan was done which showed FDG avid
management. heterogeneously enhancing soft tissue density lesion noted in
the uterine cervix, extending into upper 1/3rd of vaginal canal
Keywords:- Carcinoma Cervix, Multidisciplinary, Renal Cell and also FDG avid left external iliac lymph node. Another
Carcinoma (RCC), Synchronous. positive finding of an ill defined lesion in the right kidney
with no significantly increased FDG uptake seen at the
I. INTRODUCTION inferomedial aspect, measuring 3.1 x 3.7 cm in size, with
extension into the renal pelvis.
Cervical cancer is the fourth most common cancer in
terms of both incidence and mortality in women worldwide, To evaluate that right renal lesion, contrast enhanced
with an estimated 660,000 new cases and 350,000 deaths CT was done, that shows lobulated well circumscribed
worldwide in 2022(1) and second only to breast in India with partially exophytic ball-type lesion, infiltrating into adjacent
estimated cumulative risk of 11.6 for 2022. (2) According to perinephric fat and also invades the corticomedullary
GLOBOCAN, mortality is going to increase by 25.4% by junction at mid pole, suggests malignant neoplastic lesion,
2030, which makes it as a major healthcare problem. Its most likely RCC. (Figure 1,2).
synchronicity with other primary malignancies is rare, with
less than 5% cases only.(3)
Renal cell carcinoma (RCC) accounts for 2% of global

cancer diagnoses and deaths. Most of RCC are diagnosed
incidentally on imaging and survival is highly dependent on
imaging, with a 5-year relative survival of 93% for stage 1 to
only 12% for stage IV(metastatic disease). Patients diagnosed
with RCC face a high risk of developing antecedent,
synchronous, and metachronous primary malignancies. While
IJISRT24JUN536 www.ijisrt.com 178

Fig 1 Axial Section of Contrast Enhanced CT Scan Showing Heterogeneously Enhancing Well Circumscribed Lesion in Right
kidney (Red Arrow).
Fig 2 Coronal Section of Contrast Enhanced CT Scan Shows Right Renal Lesion and Cervical Lesion (Encircled).

After multidisciplinary team discussion, consensus was IV. CONCLUSION

made to manage the cervical cancer first due to its natural
history followed by nepherectomy for right renal lesion. For Cervical cancer among females is common and its
cervical carcinoma, she was treated with external beam synchronicity with other malignancies also going increase
radiotherapy with the curative intent, a total dose of 50 Gy in with advance and comprehensive screening protocols in
25 fractions @ 2 Gy per fraction along with weekly patients. Management of multiple primary malignancies may
concurrent cisplatin 40mg/m2 was given. She further also pose certain challenges, so it requires a multidisciplinary
received three sessions of intracavitatory brachytherapy, 7 approach for consensus and adaptation of the treatment
Gy of each. She completed the treatment and tolerated well. strategy.
After 4 weeks she was planned for nephrectomy for her renal
cell carcinoma. Conflict of Interest: None
III. DISCUSSION Financial Support: None
Malignancies detected concurrently or within three REFRENCES

months of the diagnosis of the former are referred to as
synchronous malignancies. Multiple cancers are not [1]. Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL,
uncommon; this has long been documented in the literature. Soerjomataram I, Jemal A. Global cancer statistics
2022: GLOBOCAN estimates of incidence and
Warren and Gates,(5) were the first who described mortality worldwide for 36 cancers in 185 countries.
multiple primary malignant tumours in 1932 and they CA: a cancer journal for clinicians. 2024
reported their prevalence varying from 0.4%-21.0% and May;74(3):229-63.
association of second primary malignancies with [2]. Sathishkumar K, Chaturvedi M, Das P, Stephen S,
gynaecological cancers being 1.9%-4.3%.(3,6) Mathur P. Cancer incidence estimates for 2022 &
projection for 2025: result from National Cancer
Wong et al, reported a case series of three synchronous Registry Programme, India. Indian Journal of Medical
cases of renal cell carcinoma with gynaecological Research. 2022 Oct 1;156(4&5):598-607.
malignancies, but none of them were of cervix.(7) [3]. Takeda T, Sagae S, Koizumi M, Terasawa K, Ishioka
S, Takashima S, Kudo R. Multiple primary
Rabbani et al, presented the data of 551 patients of malignancies in patients with gynecologic cancer.
primary cell carcinoma, 189 (34.3%) had multiple International Journal of Gynecological Cancer. 1995
malignancies. 74(13.43%) had synchronous, but only three Jan;5(1):34-9.
cases were of gynaecological, which shows that [4]. Padala SA, Barsouk A, Thandra KC, Saginala K,
synchronicity of RCC with gynaecological malginancies is Mohammed A, Vakiti A, Rawla P, Barsouk A.
very rare.(8) Shaukat et al, reported case series of three cases Epidemiology of renal cell carcinoma. World journal
of incidental renal cell carcinoma in pelvic malignancies, out of oncology. 2020 Jun;11(3):79.
of which one case of carcinoma cervix with RCC. Carcinoma [5]. Warren S. Multiple primary malignant tumors. A
cervix was treated with external beam radiotherapy followed survey of the literature and a statistical study. Am J
by brachytherapy while nephrectomy was done for RCC. (9) cancer. 1932;16:1358-414.
[6]. Frödin JE, Ericsson J, Barlow L. Multiple primary
Sharma et al, published a case report of synchronous malignant tumors in a national cancer registry:
renal cell carcinoma with carcinoma cervix, both were reliability of reporting. Acta oncologica. 1997 Jan
managed surgically.(10) 1;36(5):465-9.
[7]. Wong C, Plante M, Eltabbakh G. Synchronous renal
Renal cell carcinoma is the most common malignancy cell carcinoma and gynecologic malignancies.
of kidney and carcinoma cervix is also the one of the Gynecologic oncology. 2003 Jan 1;88(1):66-8.
commonest malignancy among females. But presence of [8]. RABBANI F, GRIMALDI G, RUSSO P. Multiple
synchronicity between them is very rare and only few such primary malignancies in renal cell carcinoma. The
cases have been reported so far to best of our knowledge Journal of urology. 1998 Oct 1;160(4):1255-9.
which makes this case worthy to report. [9]. Shaukat F, Mansha MA, Ali N, Khan AM, Abbasi AN.
Incidental renal cell carcinoma in pelvic malignancies.
Cureus. 2019 Jan;11(1).
[10]. Sharma M, Hussain A, Sharma M. Synchronous Renal
Cell Carcinoma with Carcinoma Cervix: An Unusual
Clinical Presentation. Journal of South Asian
Federation of Menopause Societies. 2020;8(1).

Synchronous Carcinoma Cervix With Renal Cell Carcinoma: An Incidental Finding

Uploaded by

Copyright:

Available Formats

Synchronous Carcinoma Cervix With Renal Cell Carcinoma: An Incidental Finding

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Synchronous Carcinoma Cervix With Renal Cell Carcinoma: An Incidental Finding

Uploaded by

Copyright:

Available Formats

Volume 9, Issue 6, June – 2024 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165 https://doi.org/10.38124/ijisrt/IJISRT24JUN536

Synchronous Carcinoma Cervix with

Abstract:- RCC often coexists with malignancies in the prostate,

 Conclusion Contrast enhanced MRI of pelvis was suggestive of

Renal cell carcinoma (RCC) accounts for 2% of global

IJISRT24JUN536 www.ijisrt.com 178

IJISRT24JUN536 www.ijisrt.com 179

After multidisciplinary team discussion, consensus was IV. CONCLUSION

III. DISCUSSION Financial Support: None

Malignancies detected concurrently or within three REFRENCES

IJISRT24JUN536 www.ijisrt.com 180

You might also like