Salvage lymph node dissection for metastatic castration resistant prostate adenocarcinoma

@#Presented here is a 66 year old male who is a known case of prostate adenocarcinoma gleason score 9 (4+5) and who underwent open radical retropubic prostatectomy with bilateral pelvic lymph node dissection, followed by 45 cycles of radiation therapy with continous androgen deprivation therapy. Afer completion of radication therapy, Choline PET CT was done which revealed enlarged paracaval, aortocaval and paraaortic lymph nodes. The patient then underwent exploratory laparotomy, retroperitoneal lymph node dissection which found four out of twenty five lymph nodes removed that were positive for tumor metastases. There was a significant drop in the prostate specific antigen level two months post-surgery, from 7.43 to 1.54. Androgen deprivation therapy was still continued post-operatively.

Synchronous surgical resection of double primary hepatocellular carcinoma and renal cell carcinoma

@#This paper presents a case of a 53 year old, Filipino male, known to have Chronic Hepatitis B infection, presenting with bloatedness and unintentional weight loss attributed to a 21.3cm x 18.2cm x 16.6cm right liver mass with radiographic features pathognomonic for Hepatocellular Carcinoma. An incidental finding of a right renal mass measuring 3.5cm x 3.2cm x 3.4cm is seen in the inferoposterior pole was noted. Multidisciplinary team collectively decided to proceed with outright surgical resection of both hepatic and renal masses over preoperative biopsies of the masses. Histopathologic report of the Right Hemihepatectomy and Right Partial Nephrectomy confirmed the occurrence of a Double Primary Malignancy of Hepatocellular Carcinoma Stage IB and Renal Cell Carcinoma Stage I. The postoperative course is unremarkable, and given a locoregional disease, the patient will undergo active surveillance for tumor recurrence. To the best of the authors’ knowledge, this is the first case of double primary malignancy of the liver and kidney to be diagnosed and simultaneously resected in the Philippines.Improved prognosis of cancer patients and diagnostic modalities contributed to increasing number of reported cases with multiple primary malignancy. In the absence of a set standard of care, multidisciplinary approach has become of greater value in balancing the risks and benefits of selected timely interventions to the patients.