Endocrine Abstracts

Introduction: The solitary fibrous tumor is a rare spindle cell neoplasm, originally described in the pleural cavity. However, it can occur in other locations. Multiple primary cancers are a rare entity and their incidence is described at 5.5%. We report a case associating three neoplasms: a renal cell carcinoma, a mediastinal solitary fibrous tumor and a papillary thyroid cancer.

Obervation: We report the case of a 38 year old patient with no particular medical history, who presented a cough with fever. Chest scan showed a voluminous 10 cm mass in the upper mediastinum adhering to the upper lobe of the lung along with an incidental left mediorenal mass of 9 cm extending to the hilum. The patient underwent surgery: Resection of the lung mass with an enlarged left nephrectomy. Anatomopathological examination showed a mediastinal solitary fibrous tumor and a chromophobe renal cell carcinoma. Ten years later, the patient consulted for a cervical mass. Ultrasound showed suspicious cervical adenopathies along with a right mediolobar thyroid nodule of complex appearance measuring 17*13mm graded Eutirads 4. The patient underwent a total thyroidectomy. The histological examination showed a bifocal papillary carcinoma of the right thyroid lobe. The first one measures 1.7 cm, non-encapsulated and infiltrates the peri-thyroid adipose tissue and the 2nd nodule measures 0.1 cm, non-encapsulated and non-infiltrating along with lymph nodes metastases.

Conclusion: The association between renal cell carcinoma, mediastinal solitary fibrous tumor and papillary thyroid carcinoma wasn’t described before in the literature. The coexistence of several neoplasms is rare. Common genetic and environmental risk factors seem to be involved in many cases. Multiplicity itself is not necessarily a poor prognostic factor. The role of genetic study is essential to codify these different diseases into a syndromic approach.