Synchronous Rectal Adenocarcinoma and Urothelial Carcinoma of the Bladder: Fortuitous Association or Oncogenetic Predisposition?

Synchronous primary cancers involving the rectum and the bladder are quite rare and poorly reported in the literature. We report the case of a 58-year-old non-smoking patient who presented with proctalgia with diarrhea and rectal bleeding, as well as pollakiuria and hematuria. Pelvic magnetic resonance imaging showed the presence of two tissue masses involving the rectum and the bladder, in addition to a bone lesion in the pelvis. The biopsy of the three sites (rectum, bladder and bone) was in favor of a rectal adenocarcinoma and urothelial carcinoma of the bladder, with absence of signs of malignancy for bone involvement. The PET-Scan did not show any distant lesion. The patient was treated with a trans-urethral resection of the bladder, and concomitant radio-chemotherapy for the rectum. We are going to do a review of the literature concerning this association.