Synchronous occurrence of hepatocellular carcinoma and renal cell carcinoma: A case report.

[INTRODUCTION] The occurrence of synchronous RCC and HCC is extremely rare. We report a case of 60 year old man with large hepatic mass and left renal mass.

[CASE PRESENTATION] We present a case of 56 yrs. old man with hepatocellular carcinoma and left renal cell carcinoma. The diagnosis was made after he presented with right Upper quadrant pain of 3 months duration. Abdominal ultrasound scanning and triphasic abdominopelvic CT scan shows large hepatic and left renal mass. Image guided biopsy of hepatic mass was suggestive of HCC rather than metastasis. The patient was operated, both masses were excised and pathology was suggestive of Clear cell RCC and moderately differentiated HCC. The patient is on follow up 18 months post-surgery. On 18th month post op follow up, there was right lower anterior chest wall nodule which was excised and is HCC secondary on excisional biopsy. Chest and abdominopelvic CT which were done for chest wall nodule were normal.

[DISCUSSION] Accurate diagnosis of multiple primary malignancies is very crucial for the patient management. The development of synchronous cancers in an individual raises concerns about shared genetic, environmental, and therapeutic factors.

[CONCLUSION] The diagnosis and therapeutic approach in cases of malignancy, in particular double malignancy extremely challenging. Surgery is best method for resectable cases and post op surveillance with coordinated approach with oncology is necessary for optimal patient care.