A rare case of synchronous management of gastroesophageal junction adenocarcinoma and renal cell carcinoma: is it just another oesophagectomy?

Oesophageal cancer (OC) is the seventh most common cancer worldwide and the sixth most common cause of cancer-related death [1]. Trends in OC vary greatly; squamous cell carcinoma (SCC) is the most common histological type in Eastern Asia, while in Western countries, studies show an increasing trend towards adenocarcinoma, probably due to the higher prevalence of the main risk factors: obesity and Barrett’s oesophagus. On the other hand, renal cell cancer (RCC) is the ninth most common cancer worldwide [1] and in many cases is detected as an incidental finding during investigation for non-related diseases. Even though OC is well-recognised for its frequent association with other primary malignancies in Eastern countries [2–5], adenocarcinoma of the gastroesophageal junction (GEJ) is rarely correlated with other primary synchronous tumours in Western countries. The frequency of multiple primary malignancies in the same or different organ system/s ranges from 2% to 17% [2–5].The most common sites of other primary malignancies associated with EC are head and neck, lungs, and stomach; a fact that can be easily explained by the simultaneous exposure in the same aetiologic carcinogenic agents (i.e. tobacco and alcohol) [6]. However, only few cases of synchronous OC and RCC have been reported in the literature to date [7–10], suggesting that this is an extremely rare clinical scenario with a lack of existing guidelines for the appropriate therapeutic management. Taking into account the postoperative morbidity of oesophageal surgery, the decision for the treatment of a patient with synchronous renal cancer and gastroesophageal junction cancer is of paramount importance, even more if there is a plan for radical nephrectomy, which could compromise patient’s renal function. Herein, we present a case of synchronous gastroesophageal junction adenocarcinoma and incidentally discovered clear cell renal cell carcinoma that was successfully treated in our department with a one-stage operative procedure.
A 51-year-old male Caucasian patient was referred to our department complaining of progressively worsening epigastric pain as well as dysphagia of recent onset. He had insignificant past medical history, while no history of tobacco use, or excessive alcohol ingestion was reported. Physical examination was unremarkable. Haematological examination and blood chemistry were within normal limits. The patient subsequently underwent an oesophagogastroscopy, which revealed...


Pełna treść artykułu...