Considerations upon a case of synchronous primary malignancies: adenocarcinoma of the sigmoid and clear cell carcinoma of the right kidney.

Synchronous primary colon and renal cancer is a rare but real clinical entity reported with variable incidence. An 81-year-old man admitted for abdominal pain and melena is diagnosed with right colic tumor by colonoscopy and with simultaneous right kidney tumor by CT-scan. The patient is adequately prepared and scheduled for laparotomy. Both tumors are resected in the same surgical session with curative intent - right hemicolectomy and right radical nephrectomy. The patient recovered well and was discharged after 10 postoperative days. The microscopic examination indicated an adenocarcinoma in the sigmoid and a clear cell renal carcinoma in the kidney. Immunohistochemical staining did not find any compatibility between those tumors. The patient started chemotherapy and is under appropriate oncologic follow-up. Modern investigations allow detection of simultaneous malignancies making possible the planned simultaneous resection of both. Histopathologic examination will proof the diagnosis of primary different malignancies.

Assessment of Gleason system use on different types of prostatic tissue samples.

One of the well-known and accepted methods of prostatic adenocarcinoma grading is Gleason system. The authors made a retrospective analysis of 221 prostatic adenocarcinomas divided into three groups (transvesical prostatectomies, transurethral resections and needle biopsies) following the type of surgical procedure used for drawing the tissue. Gleason scores and comparison between odd and even Gleason scores were assessed in the entire group and in each subgroup. High scores prevailed, meaning a tendency towards a low grade of differentiation. Even scores also prevailed meaning, on one hand, that, often, the examined specimen reveals only one pattern and, on the other hand, that surgical procedures as transurethral resections and unique needle biopsies cannot offer a sufficient material for examination, the multicentricity of prostatic carcinoma being well known.

Comparative study between prostatic carcinoma G1-G3 and Gleason grading systems.

The need of an accurate and prognostically valuable method for grading the prostatic carcinoma resulted in, in the last decades, a large number of systems, none of them succeeding in being unanimously accepted by the pathologists family. The authors selected and reassessed using Gleason system a group of 221 cases with prostatic adenocarcinoma previously diagnosed using a combined G1-G3 system. The results were converted from Gleason system to G1-G3 system and then compared with the initial diagnostics. The group was divided, following the type of surgical procedure used for drawing the tissue, into three groups: transvesical prostatectomies (TVP), transurethral resections (TUR) and needle biopsies (B). The concordance between the two systems was good, even the number of TUR and B specimens was significant (85% of the studied group) showing that any of them can be successfully used in current practice, depending only on pathologist's experience.