Simultaneous Urothelial Carcinoma in the Upper Urinary Tract and Contralateral Renal Cell Carcinoma: A Case Report.

Abstract

Introduction: Although urological surgeons often diagnose cases of simultaneous double cancers of the urinary tract in our clinical practice, few reports have shown that treatment strategies achieve both anticancer effects and preservation of renal function for simultaneous contralateral renal cell carcinoma and urothelial carcinoma. Although there are many options for the treatment of renal cancer, such as immunotherapy and - drugs, and many surgical procedures, such as laparoscopic surgery and robot-assisted surgery, no treatment strategy has been established for double cancer of the bilateral urinary tracts. We encountered a case in which contralateral renal surgery was performed under a precise preoperative plan; as a result, the introduction of dialysis could be avoided, and the anticancer effect could be maintained.

Case presentation: A 73-year-old man was diagnosed with contralateral left renal cell carcinoma and right ureteral cancer. Initially, the patient underwent laparoscopic radical nephroureterectomy for right ureteral urothelial carcinoma. Subsequently, robot-assisted laparoscopic partial nephrectomy for left renal cell carcinoma was performed after treatment with the molecular-targeted agent, pazopanib. Even after partial nephrectomy, renal function was maintained, and dialysis was avoided.

Conclusion: In cases of simultaneous renal cell carcinoma and contralateral ureteral cancer, it is possible to preserve both anticancer effects and renal function using careful treatment strategies.