Case Report: Synchronous germline

Background: Synchronous occurrence of choroidal melanoma and clear cell renal cell carcinoma (ccRCC) is exceptionally rare and traditionally suspicious for Case presentation: A 64-year-old Chinese male with a 2-year history of progressive vision loss in his right eye was found to have an intraocular melanocytic tumor by multimodal imaging. Staging PET/CT incidentally detected a hypermetabolic mass in the right kidney. Guided by imaging and multidisciplinary team (MDT) discussion, the patient underwent right eye enucleation followed by right partial nephrectomy. Histopathology and immunohistochemistry supported two independent localized primary tumors: mixed-cell choroidal melanoma (AJCC 8th edition stage II, pT2aN0M0) and ccRCC (pT1bN0M0, WHO/ISUP grade 2). Postoperative comprehensive genomic profiling provided supportive molecular evidence, showing a Conclusion: This case illustrates that multimodal imaging and multidisciplinary assessment can guide curative-intent management for synchronous early-stage tumors, while postoperative genomic profiling can add supportive molecular evidence and inform genetic counseling. Low-VAF renal genomic findings should be interpreted cautiously and in the context of histology and immunophenotype. Long-term surveillance remains essential.