Supplementary Material for: Synchronous Ampullary Adenocarcinoma and Renal Cell Carcinoma: A Rare Case Report and Literature Review

Introduction: Synchronous multiple primary malignancies (SMPMs) represent a complex oncological phenomenon with significant clinical implications. The concurrent presentation of ampullary adenocarcinoma and renal cell carcinoma (RCC) constitutes an exceptionally rare clinical entity, with minimal documented cases globally and no previous reports from Vietnam. This study examines the epistemological and therapeutic dimensions of this rare oncological convergence.
Case Presentation: We present a comprehensive analysis of a 66-year-old male with synchronous ampullary adenocarcinoma and RCC. The patient presented with right upper quadrant pain, and diagnostic evaluation revealed a 14×16mm ampullary lesion and a 42×44mm right upper pole renal mass. Following multidisciplinary consultation, the patient underwent combined pancreaticoduodenectomy, right nephrectomy, and lymphadenectomy. Histopathological examination confirmed ampullary adenocarcinoma in situ and grade 2 clear cell RCC. The patient's postoperative course was uneventful, with preserved functional status at nine-month follow-up.
Conclusion: The synchronous occurrence of ampullary adenocarcinoma and RCC presents substantial diagnostic and therapeutic challenges. This first documented Vietnamese case demonstrates the feasibility of curative surgical intervention despite the technical complexity involved, emphasizing the importance of integrated multidisciplinary management in optimizing outcomes for patients with rare synchronous malignancies.