Breast Cancer with Synchronous Renal Cell Carcinoma: A Rare Presentation

Abstract

A 45-year-old female patient presented to Department of Surgical Oncology with chief complaints of pain abdomen and loss of appetite for last six months which was relieved on oral analgesics. There is no relevant past or family history. Clinically per abdomen and pelvic examination was normal. During general examination we found 2x2 cm mobile, hard lymph node in right axilla and the ipsilateral breast showed 8x6cm mobile lump in upper outer quadrant. Contra lateral breast and axilla were normal. Considering this as a carcinoma right breast stage III A, further routine and metastatic workup in the form of ultrasound abdomen and pelvis, X-ray of chest and bone scan as per our institute protocol was done.Mammogram showed nodular, irregular, homogenous density with tail like extension of size 2.9 cm x 2.8 cm, with a satellite lesion in the right axillary tail of size 1.6 cm x 1.3 cm, highly suggestive of malignancy, (BIRADS V category; [Table/ Fig-1a&b]). Multiple axillary nodes were present with largest size of 1.2 cm x 0.8 cm. FNAC from breast mass was suggestive of ductal carcinoma. FNAC of axilla is not required and indicated only if no lump is palpable clinically to rule out metastasis. Preoperative staging of axilla was clinical. Ultrasound abdomen showed a mass in upper pole of the right kidney. Other metastatic work up in the form of X-ray chest, bone scan and routine haematological tests were within normal limit. In order to evaluate the renal mass contrast enhanced computed tomography scan of abdomen was done, which showed heterogeneously enhancing mass lesion in upper and mid pole of the right kidney abutting the liver and ascending colon with focal loss of fat planes, renal vein and IVC was normal Mammogram showing nodular irregular homogenous density present in upper outer quadrant of right breast (BIRADS V -highly suggestive of malignancy).

Clinical Characteristics and Prognosis Associated with Multiple Primary Cancers in Breast Cancer Patients

“…Although many studies have been performed regarding MPCs, these have usually taken the form of case reports [ 11 12 13 ]. There have been several analytic clinical studies on MPCs, but few analytic clinical studies related to breast cancer with MPCs have been reported.…”

Synchronous Clear Cell Renal Carcinoma And Bilateral Invasive Duct Carcinoma Breast- Rare association

“…Kurlekar U A et al reported a case of unilateral infiltrating lobular carcinoma of breast and clear cell renal carcinoma which was non reactive for estrogen and progesterone receptors . Ravi Arjunan et al [9] also reported a case of Infiltrating ductal carcinoma of breast with papillary RCC which was non reactive for estrogen and progesterone receptor analysis. Renal cell carcinoma can be seen with other malignancies such as colorectal carcinoma, gynaecological malignancies, lung ,nasopharyngeal and haematological malignancies.…”

Incidental Renal Cell Carcinoma in Pelvic Malignancies

“…Cancer in the prostate, bladder, lung, breast, colon and rectal cancer, malignant melanomas (MM) and non-Hodgkin's lymphomas (NHL) are the most common malignancies associated with RCC [2]. Arjunan et al reported a rare case of synchronous presentation of carcinoma breast with RCC [7].…”