Fibrolipoma del espacio perineal intraescrotal / Fibrolipoma of the intrascrotal perineal space

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[Prostate cancer and bilateral synchronic renal tumors. Case report]. / Cáncer prostático y tumor renal bilateral sincrónicos. A propósito de un caso.

OBJECTIVE: To report one case of synchronic prostate cancer and bilateral renal tumors, radiologically suggestive of renal cell carcinoma. METHODS: We present the case of a 63-year-old diabetic male, heavy smoker, who presents at the outpatient office complaining of right upper quadrant abdominal pain and mild obstructive voiding symptoms. Abdominal examination was negative and digital rectal examination revealed a rock hard irregular prostate. RESULTS: The prostatic biopsy showed a moderately differentiated prostate adenocarcinoma. Abdominal ultrasound showed the existence of a 6 cm heterogeneous complex tumor at the lower pole and middle portion of the right kidney, and another at the upper pole-middle left kidney. CT scan confirmed the tumors, which enhanced with contrast. Chest x-ray and bone scan were negative for metastases. Two fine-needle aspiration biopsies of the right kidney tumor were unsuccessful and patient refused to undergo further diagnostic procedures. Treatment for the prostate cancer with LHRH analogues and antiandrogenic drugs was started. The three-month follow-up CT scan showed no variation. CONCLUSIONS: Despite the absence of a histological diagnosis due to refusal of the patient, CT scan images are typical of bilateral renal cell carcinoma, supporting the idea that in the presence of a genitourinary neoplasia we should suspect and rule out a synchronic second tumor of the same apparatus.