Quadruple primary neoplasms of the skin, colon, kidney and chronic lymphatic leukemia: a case report
Keywords:colorectal neoplasms, renal neoplasms, chronic lymphatic leukemia, skin basal cell carcinoma
Multiple primary neoplasms of different systems represent rare and clinically important entities. We present the 75-year old male patient in whom synchronous colon, renal and lymphatic malignancies (chronic lymphatic leukemia) were incidentally diagnosed 22 years after surgery for facial basal cellular skin cancer and 15 years after left lobectomy for follicular adenoma of the thyroid. Patient was admitted for the treatment of pneumonia. Incidentally, severe leukocytosis was found that persisted to treatment. Bone marrow biopsy showed chronic lymphatic leukemia. Due to microcytic anemia, colonoscopy was performed that revealed tumor in the ascending colon involving two thirds of the lumen. Subsequent abdominal imaging (ultrasound and CT) demonstrated large (7.7 cm) kidney neoplasm. Right hemicolectomy and left nephrectomy were performed. This represents the unique presentation of four primary neoplasms, underlying the need for more intensive use of screening methods in patients with previous malignancies.
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