Recurrent papillary renal cell carcinoma with concomitant ipsilateral upper urinary tract urothelial carcinoma and metachronous urothelial carcinoma of the bladder

Concomitant renal cell carcinoma (RCC) and ipsilateral upper urinary tract urothelial carcinoma (UTUC) is very uncommon, with only about 50 reported cases in the literature.1 Patients who developed synchronous, ipsilateral RCC and UTUC are on average 64.5-years-old, are 3-fold more likely to have disease in the left kidney and are more often men.2 Of these, 24% have a significant smoking history and 34% ultimately develop bladder malignancy. To our knowledge, there have been no reported cases of simultaneous UTUC with recurrent RCC in the same kidney. Here, we present a novel case of recurrent RCC in a 59-year-old male with synchronous, ipsilateral UTUC and metachronous urothelial carcinoma of the bladder and prostate. We illustrate an unusual clinical phenomenon and highlight novel predictive markers and prognosticators to aid in monitoring and managing similar disease presentations.