Multiple primary malignancies of thyroid, kidneys and prostate: synchronous and metachronous presentation in one patient

Synchronous appearance of 2 different primary malignant neoplasms is a rare phenomenon. We describe a patient with Synchronous presentation of 3 primary carcinomas included prostate carcinoma [PCA] and bilateral renal cell carcinoma [RCC]. papillary and classic clear cell types. Furthermore previous history indicated the presence of thyroid papillary carcinoma [TPCA] that was resected 10 years ago. Immunohistochemistry was applied to confirm the primary nature of these neoplasms. The patient is in a good health 1 year following total prostatectomy and bilateral partial nephrectomies. We report this very rare case, which up to our knowledge is the first case that represents the combination of carcinomas of thyroid, prostate and both kidneys in one patient and we emphasize the importance of immunohistochemistry to document the primary nature of such neoplasms

Investigation of the biological significance of p53 tumor suppressor gene and Ki-67 in colorectal carcinoma resected from Saudi patients: An immunohistochemical analysis

p53 protein accumulation has been shown to be an unfavorable prognostic parameter in many human cancers, but findings in colorectal carcinoma [CRC] are equivocal. The objective of this study is to evaluate the value of p53 and Ki-67 as prognostic markers in patients with colorectal carcinoma. We conducted a retrospective analysis on 56 colorectal cancer specimens resected at King Abdulaziz university hospital, Jeddah, Saudi Arabia [40 cases of left colon and 16 from right colon]. Immunohistochemistry [IHC] was performed on formalin fixed paraffin embedded tissue using the avidin-biotin peroxidase complex method. Antibodies to p53 [DO7] and Ki-67 were used. This was correlated with the following clinicopathologic parameters: patient sex, age and survival; pathological stage, and grade of the tumors. Among the 56 cases of colorectal cancer [male/female=1.3; mean age 54.9 years, range 30-80 years], 85.7% [n=48] of tumors were positive for p13 IHC. Ki-67 was positive in 94% [n=53]. The p53 positivity in different stages was as follows [2/2 stage A, 23/28 stage B, 15/18 stage C and 8/8 stage D]. The positivity of p53 according to tumor differentiation was as follows: [well differentiated 6/6, moderately differentiated 38/45, poorly differentiated 4/5]. P53 was positive in 34/40 of left colon [including rectosigmoid] and in 14/16 of right colon carcinoma. Imunoreactivity for p53 was seen in adenomatous epithelium only in 8/22 cases. Although p53 and Ki-67 expression expresse4 strongly in cancer compared to normal tissue [p<0.05], there was no relation with survival, grade or Dukes' stage of the tumor. P53 cannot be considered as independent prognostic marker in colorectal carcinoma