An unusual coincidence of multiple synchronous kidney tumors with a metachronous rectal adenocarcinoma.

In synchronous surgery specimens (right-sided nephrectomy and left-sided partial nephrectomy), a unique combination of a papillary (chromophil) renal cell carcinoma (4 x 3.7 x 3.5 cm) and a renal oncocytoma (11 x 10 x 9 mm) in the right kidney and a renal carcinoid (2.5 x 2.3 x 1.1 cm) in the resected part of the left kidney has been found. This multiplicity and bilaterality, based on the findings of three distinct histogenetic types of kidney tumors, was accompanied by a metachronous rectal adenocarcinoma discovered 14 months later. After surgery, no radiation or other oncologic therapy was given. At present, our patient is well without any evidence of neoplastic disease three years after primary diagnosis. To the best of our knowledge, this is the first case of a combination of three distinct histogenetic types of synchronous renal tumors associated with a metachronous rectal adenocarcinoma treated with simple surgery. In the absence of cytogenetic studies, the possibility of a the presence of a hereditary renal cancer syndrome must be considered.