Gastric Carcinoma and Renal Cell Carcinoma as an Atypical Presentation of Multiple Primary Malignancies

A Case Report and Review of the Literature

J. A. Martín-Pérez; C. Torres-Silva; R. Tenorio-Arguelles; D. A. García-Corona; S. Silva-González; J. A. Dominguez-Rodriguez; I. De Alba-Cruz; J. F. Nagore-Ancona; J. A. González-Luna; K. A. López-Bochm


J Med Case Reports. 2020;14(234) 

In This Article

Materials and Methods

Inclusion Criteria

This systematic review was designed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).[21]

All articles written in English and Spanish related to cases of synchronous gastric and/or renal carcinoma were included. Exclusion criteria were articles not meeting the criteria for the definition of synchronous cancer.[1]

Search Strategy

The study design was developed and strictly followed by all participating authors. Identification of eligible studies was performed through a systematic literature search using Medline/PubMed, Science Direct, Scopus, and Google Scholar.

The end date for the literature search was April 1, 2020. The following keywords were used in the search algorithm: ("cancer OR tumor OR neoplasia") AND ("synchronous double primary") AND ("Gastric OR Gastric Adenocarcinoma") AND ("renal carcinoma OR kidney carcinoma). Two independent reviewers performed the literature review. The reference lists of eligible articles were manually evaluated to detect potentially relevant articles. The selection process for this article is shown in Figure 6.

Systematic Review and Data Extraction

The study design did not use an exclusion factor due to the scarcity of publications on the subject. After removing duplicates, two reviewers independently selected all abstracts and articles for the full-text review. Data analysis was extracted from full-text articles.

Statistical Analysis

The PRISMA flowchart was generated by Cochrane RevMan software version 5.2.

The initial literature search identified 1172 articles. Of these, 1159 articles were excluded as they did not meet the review criteria, were duplicates, were not in the included language, were studies without data of interest, or were letters/opinions from experts. Thirteen studies were selected which met the inclusion criteria. Manual search and cross-checking of reference lists of included articles yielded no additional relevant articles. Figure 1 shows a flow diagram illustrating the identification and inclusion/exclusion processes in the study (Figures 2, 3, 4, 5, 6).

Figure 1.

CT scan in which the left kidney cancer is observed with dimensions of 140 × 97 × 85 mm

Figure 2.

Product of partial gastrectomy (antrum and pylorus) that measures 100 × 60 × 40 mm; the cut of this area is identified

Figure 3.

Left kidney surgical piece that measures 160 × 100 × 75 mm, in the upper pole and mid-region solid multinodular lesion

Figure 4.

GC. Histopathological examination of antrum and pylorus (Hematoxylin and Eosin (H&E) staining x 40). In the lamina propria, individual cells of medium size are observed, with moderate pleomorphism and some in a signet ring

Figure 5.

RCC. Histopathological examination of the left kidney (H&E ×20) where large cell sheets with optically clear cytoplasm and round nuclei of fine chromatin are observed

Figure 6.

PRISMA flow diagram detailing the search and identification strategy for the studies used in data synthesis