Abstracts
2002 Digestive Disease Week

# 104920 Abstract ID: 104920 Concomitant Colorectal Cancer and Renal Cell Carcinoma: An Apparent Predisposition for Other Malignancies
Harvey G Moore, Robert Finch, Anju S Morarka, Paul Russo, Farhang Rabbani, Arnold Markowitz, Colleen Gately, Jose G Guillem, New York, NY

PURPOSE: To determine the characteristics of a cohort of patients with pathologically proven colorectal cancer (CRC) and renal cell carcinoma (RCC). METHODS: The prospective Colorectal Service and Urology Service databases, as well as the institutional Tumor Registry, were used to identify a cohort of 49 patients with biopsy proven CRC (N= 46) or advanced adenomatous lesions requiring formal resection (N= 3), and biopsy proven RCC. Details regarding colorectal and renal tumor characteristics, additional primary malignancies, and family cancer history were reviewed. RESULTS: Most patients were male (N= 36), with a median age of 62 at CRC diagnosis. Only 2 (4%) patients were diagnosed with CRC at age 50 or under. Most tumors were colonic (76%) versus rectal (24%), and fully 39% were located proximal to the splenic flexure. Tumors were predominantly early stage (70% Stage I/II), and well to moderately-well differentiated (90%). Renal cell tumors were diagnosed at a median age of 58, and were mostly clear cell type (63%). The CRC and RCC presented as synchronous lesions (interval < 6 months) in 17 (35%) patients. Seventeen patients (35%) had at least one additional primary malignancy, including 5 women with breast cancer (5/13 women, 38%). Other additional primaries included lymphoma (N= 3), appendiceal carcinoid (N= 2), and pancreatic tumors (N= 2). A first-degree relative affected by CRC was noted in 27% of cases. Ten patients had either a first or second-degree relative affected with breast cancer, including 5 patients with a family history of both CRC and breast cancer. One patient had a first-degree relative affected by CRC, breast cancer, and RCC. Overall, a total of 29 patients (59%) had a positive family history of at least one malignancy. CONCLUSIONS: Patients with both CRC and RCC have an apparent predilection for additional malignancies, especially breast cancer in women. Unlike classic familial CRC syndromes such as FAP and HNPCC, in this setting CRC does not appear to occur at an early age. The frequency of additional primaries should prompt thorough screening for common malignancies in any patient with a history of both CRC and RCC.