Involvement of the urogenital tract in patients with five or more separatemalignant neoplasms - Case and review

Occurrence of metachronous primary malignant neoplasms (PMN) in five or mor e different organs and tissue of the same patient is a very rare event. The present paper reports on a female patient who experienced Hodgkin's diseas e of nodular sclerotic type (stage IV), carcinoma of the cervix uteri (stag e I), adenocarcinoma of the rectum (Dukes A), and a well-differentiated ade nocarcinoma of the stomach (pT1) before she demonstrated multicentric trans itional cell carcinoma of the renal pelvis and ureter (pT3b G2-3) and of th e bladder (pTa G2). Although an increased inherent predisposition of the pa tient to exhibit those neoplasms, similar to Lynch syndrome II, is to be di scussed, her previous treatments with cyclophosphamide and external radioth erapy are likely to explain at least the occurrence of urothelial cancer. H owever, a report on renal pelvis and ureteral cancer induced by cyclophosph amide or irradiation is a rarity in itself.