An unusual case of synchronous renal cell carcinoma in a horseshoe kidney and intrahepatic cholangiocarcinoma

Abstract

We report an unusual FDG-PET/CT case of synchronous renal cell carcinoma of a horseshoe kidney and intrahepatic cholangiocarcinomaA 70-year-old man presented with 1 day of frank hematuria, on a background of 4 months' treatment for polycythemiaCT identified the horseshoe kidney and isthmic tumor, with the renal lesion considered to be the primary neoplasm, and the hepatic lesion considered metastaticFDG-PET/CT was performed to exclude further metastasesHistopathologic assessment revealed synchronous primary renal cell carcinoma (RCC) of the horseshoe kidney isthmus and intrahepatic cholangiocarcinomaThe polycythemia was attributed to a paraneoplastic effect of the RCCHelpful factors in identifying synchronous primary tumors in this case were the absence of multiple metastases, and in more typical locations (bone for RCC; lymph nodes for cholangiocarcinoma) and the morphologic feature of minor capsular retraction adjacent to the liver lesion. Copyright © 2009 by Lippincott Williams & Wilkins.