Transitional cell carcinoma of the bladder, adenocarcinoma of the prostate, and renal cell carcinoma are common urogenital cancers, but a synchronous triple urogenital cancer is extremely rare. The standard treatment for the triple urogenital cancer has not yet been established. The strategy of management should be determined based on the stage and grade of the most life-threatening cancer. We report a case of synchronous 4 tumors in a 66-year old male, which consisted of a renal cell carcinoma of the right kidney, a transitional cell carcinoma of the bladder, a adenocarcinoma of the prostate, and a hamartoma of the lung. Radical cystectomy with ileal conduit, partial nephrectomy, and adjuvant chemotherapy with Gemcitabin and Cisplatin was performed. At a 16-month follow-up, metastasis to the rectum was found, and rectal obstruction was present in the patient. After transverse colostomy, chemotherapy and radiation therapy was initiated.
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