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\nSynchronous primary gastric and renal tumors: a case report  \nSalma Merhaben*,1, Asma Ben Mohamed1, Amal Khsiba1, Moufida Mahmoudi1, Salwa Nechi2, Emna Chelbi2, Houda Kilani2, Manel Yakoubi1, Mohamed Lamine Hamzaoui1, Mouna Medhioub1 & Mohamed Moussadak Azouz1  \n1 Gastroenterology Department, Mohamed Taher Maamouri Hospital, Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia  \n2 Histopathology Department, Mohamed Taher Maamouri Hospital,Eezzdine Chelbi Avenue Mrezgua, Nabeul, 8000, Tunisia  \n*Author for correspondence: Tel.: +216 5348 8494; [salma.merhaben27@gmail.com](salma.merhaben27@gmail.com)  \nSynchronous multiple primary cancers of the stomach and kidney are very rare, only 45 cases of synchronous multiple primary cancers of the stomach and kidney had been reported in the literature up until 2020 . Thus far, no particular risk factors have been identified. We present a case of synchronous multiple primary cancers of the stomach and kidney in a 67-year-old female presenting with a 3-month history of vomiting and abdominal pain. The diagnosis of gastric adenocarcinoma with signet ring cells was confirmed through upper endoscopy with biopsies, while CT-guided biopsies of the renal tumor confirmed the diagnosis of primary kidney neoplasm.  \nPlain language summary: Having more than one cancer at the same time is known as multiple primary malignancies. Having cancers in both the stomach and kidney at the same time is even rarer, with only 45 cases reported in literature. The exact causes of such cancers occurring together are not yet known. We present a 67-year-old woman who was diagnosed with synchronous multiple primary cancers of the stomach and kidney. She presented with vomiting and abdominal pain. The diagnosis of gastric cancer was confirmed through upper endoscopy with biopsies, while biopsies of the renal tumor confirmed the diagnosis of primary kidney cancer.  \nFirst draft submitted: 24 January 2023; Accepted for publication: 2 May 2023; Published online:  \n16 May 2023  \nKeywords: clear cell renal carcinoma • gastric cancer • multiple primary malignancies • renal cancer • signet ring cells  \nThe number of cases of multiple primary malignancies has risen in recent years, this is partly attributed to the aging population and advancements in diagnostic techniques. The prevalence of multiple primary neoplasms ranges from 0.73 to 11 .7%[1,2] .  \nWarren and Gates proposed three diagnostic criteria for multiple primary malignancies in 1932: each tumor  \nmust present definite features of malignancy; each neoplasm must be topographically separate and distinct; and the possibility of one being a metastasis of the other must be ruled out [3] . Synchronous tumors refer to cases in which a second primary cancer is diagnosed within 6 months of the initial neoplasm [3] .  \nGastric cancer is a common diagnosis, with over one million cases reported worldwide each year. It is the fifth-most commonly diagnosed cancer globally [2] . The incidence of another synchronous primary tumor being present along with a primary gastric cancer varies from 0.7 to 11%[4–8] . with the most common synchronous sites being colorectal, lung and liver cancer [8,9] .  \nThe simultaneous diagnosis of primary renal and gastric malignancies is even rarer. Only 45 cases of synchronous multiple primary cancers ofthe stomach and kidney had been reported in the literature up until 2020 .  \nWe have an intriguing case study to present, featuring a 67-year-old female patient with synchronous renal cell carcinoma and gastric adenocarcinoma.  \n10. 2144/fsoa-2023-0009  2023 The Authors Future Sci. OA (2023) FSO865 eISSN 2056-5623  \nCase Report Merhaben, Ben Mohamed, Khsiba et al.  \nFigure 1 . Upper endoscopy showing the antropyloric tumor.  \nFigure 2 . A computed tomography image showing an exophytic hypervascular mass of the inferior pole of the left kidney.  ","cbCaieJwnUTPgh6y","https://ap.wps.com/l/cbCaieJwnUTPgh6y","pdf",14293985,"English","# Case presentation\n## Symptoms and history\n## Physical and laboratory findings\n## Diagnostic procedures and pathology\n# Background and diagnostic framework\n## Multiple primary malignancy criteria\n## Synchronous tumor definition\n## Rarity of combined gastric and renal cases","[{\"question\":\"What symptoms did the 67-year-old patient present with?\",\"answer\":\"The patient had a 3-month history of vomiting and abdominal pain, along with poor appetite and a 10 kg weight loss.\"},{\"question\":\"How was the gastric diagnosis confirmed?\",\"answer\":\"Upper endoscopy with biopsies confirmed gastric adenocarcinoma with signet ring cells.\"},{\"question\":\"How was the renal tumor diagnosis confirmed?\",\"answer\":\"CT-guided biopsies of the renal tumor confirmed the diagnosis of a primary kidney neoplasm.\"}]","Synchronous primary gastric and renal tumors: a case report | PDF",1790243880,13]