Triple synchronous tumours of the urinary system with different histologies: a case report.

We present the case report of a male patient with a diagnosis of synchronous kidney, bladder and prostate tumours with different histologies: renal oncocytoma, urothelial carcinoma of the bladder, and adenocarcinoma of the prostate. This is the first case report described in the literature in which a complete surgical resection of triple tumours has been performed with surgery in a single session. Recent advances in the field of genetics enable the surgeon to hypothesise new strategies in the early treatment of synchronous tumours, particularly when a number of common tumour markers are positive. One such marker recently identified is the prostate-specific membrane antigen (PSMA), present with high expression in carcinoma of the prostate and in the vascular endothelium of solid tumours; only overexpression of PSMA is to be regarded as diagnostic, inasmuch as this antigen is normally expressed in the renal tubular epithelium. Recent knowledge in the field of genetics has led to new strategies for the early treatment of synchronous tumours, but clinical data and instrumental diagnostics are still of fundamental importance, in that they may enable the surgeon to diagnose the presence of synchronous tumours at an early stage. The execution of prompt surgical treatment remains of basic importance for the purposes of guaranteeing oncological radicality also of synchronous tumours, in association with more sensitive and accurate instrumental diagnostics.