Retroperitoneal cystic metastasis from a small clear cell renal carcinoma

A 39-year-old housewife was referred to our hospital for the treatment of a small renal tumor. A 25 x 35 mm cystic mass that had been detected by computerized tomography scan just caudal to the renal hilus proved to be a metastasis from the renal carcinoma of clear cell type. The pathogenesis may have been due to tumor cells obstructing a lymphatic vessel draining the kidney. Cystic metastasis from renal cell carcinoma is very rare and this appears to be the second published case in the world.     

Solitary metachronous contralateral adrenal metastasis from renal cell carcinoma

Malignant involvement of the contralateral adrenal gland in cases of renal cell carcinoma is extremely rare. We report a case of solitary metachronous contralateral adrenal metastasis occurring 7.5 years after radical nephrectomy. The metastasis was treated with adrenalectomy and steroid replacement. Thirty months later, the patient remained without evidence of disease. This very rare presentation can prove to be a diagnostic challenge. Appropriate aggressive surgical treatment is warranted.     

Pancreatic metastasis from clear cell renal carcinoma: a clinical case

Renal cell carcinoma rarely metastasizes to the pancreas. In this report we describe a case of late pancreatic metastases in a seventy-year-old woman, surgically treated 21 years before for renal clear-cell carcinoma. Preoperative staging revealed the presence of four pancreatic lesions. A distal pancreatectomy and splenectomy were performed, and the postoperative period was complication-free. Histopathological analysis revealed metastases from renal clear-cell carcinoma. This case shows that in patients operated on for renal clear-cell carcinoma we have to consider the possibility of late metastases to the pancreas. Therefore, these patients should be submitted to long-term follow-up. In keeping with the current literature, we advocate aggressive surgical treatment in pancreatic metastases from renal clear-cell carcinoma.     

Laparoscopic adrenalectomy for large adrenal metastasis from contralateral renal cell carcinoma.

We present herein the case of a patient with solitary metachronous contralateral adrenal metastasis from renal cell cancer. The patient had undergone left radical nephrectomy and adrenalectomy for localized renal cancer 7 years previously. Laparoscopic transperitoneal right adrenalectomy was performed. The postoperative period was uneventful. Histology showed right adrenal metastasis from renal cancer. At 6-month follow-up, there was no evidence of recurrence.     

Pancreatic metastases. A case report--solitary pancreatic metastasis from a clear cell renal cell carcinoma

Three years after right nephrectomy for stage II (T2N0) clear cell carcinoma, a 51-year old man presented with upper digestive tract bleeding. Endoscopic examination revealed a duodenal mass. Imaging modalities showed the lesion in the head of the pancreas, with duodenal wall invasion, and raise the question of a pancreatic metastasis. The anatomopathology result of the resection specimen confirms the imaging diagnosis.     

Gastric metastasis of clear cell renal carcinoma

We report the case of a patient operated in 2003 for renal clear cell carcinoma (CCRC), when left nephrectomy was performed. In the years following occur: lung (2004) and brain (2006) metastasis, pathological bone fracture in right femur (2007), which needed a complex treatment: polichimiotherapy, cobaltotherapy, right temporal metastasectomy, right femoral fixation with metal rod. In our clinic was hospitalised for serious upper gastrointestinal bleeding, severe anaemia (haemoglobin 5.8 g%, hematocrit 18.3%) produced by a ulcerated gastric metastasis. The inefficiency of medical treatment, patient and family desire to operate, have led us to practise Péan type gastrectomy necessary for palliative role (raising the hemorrhagic metastasis). Scarcity of the gastric metastasising of CCRC are discussed and also the surgical indication in the context of a plurimetastatic patient.     

Simultaneous, contralateral hypernephroma and renal transitional cell carcinoma

The second case of simultaneous, contralateral hypernephroma and renal transitional cell carcinoma is described. Methods of managing bilateral renal tumors are reviewed.     

Simultaneous diagnosis of a metanephric adenoma and a clear cell carcinoma of the contralateral kidney

Metanephric adenoma of the kidney is a rare, newly recognized entity of a unique benign renal tumor. Clinically, pain, hematuria and palpable mass are the most common presenting signs. Females predominate by well over 2:1. A higher incidence of polycythemia is often found in these patients. Only a few cases of this type of adenoma have been reported in the literature. We report on a 78-year-old female patient with a metanephric adenoma of the left kidney, which showed typical clinical, radiologic, microscopic and immunohistochemical findings. A clear cell carcinoma of the contralateral kidney was also discovered and treated.     

Solitary contralateral adrenal metastasis after nephrectomy for renal cell carcinoma

Malignant involvement of the contralateral adrenal gland in cases of renal cell carcinoma is extremely rare. Solitary metachronous metastatic involvement of the contralateral adrenal gland from renal cell carcinoma is rarely diagnosed during life. In fact, clinical signs and symptoms of adrenal insufficiency are rare in these patients. We report a case of renal cell carcinoma with solitary metachronous contralateral adrenal metastasis occurring 9 years after radical nephrectomy.     

Simultaneous contralateral renal transitional cell carcinoma and renal carcinoma: Case report of eight-year survival

This is the third reported case of simultaneous contralateral renal transitional cell carcinoma and renal cell carcinoma. The patient is an eight-year survivor with no evidence of metastases from simultaneous contralateral renal transitional cell carcinoma and renal cell carcinoma. General methods of management are discussed.     

A renal cell carcinoma metastasis to the contralateral perirenal fat : a case report

A 53-year-old woman was admitted with right lower abdominal pain in November 1993. Computed tomography (CT) revealed a right renal tumor, suspected to be a renal cancer. She underwent right radical nephrectomy in December 1993. The pathological diagnosis was clear cell carcinoma, pT2, grade 2. In May 2006, follow-up CT showed a tumor arising from the left perirenal fat. Laparoscopic tumor excision was performed in August 2006. The pathological diagnosis was metastatic clear cell carcinoma.     

Vaginal metastasis from renal cell carcinoma

Vaginal metastases in renal cell carcinoma (RCC) have been reported in rare situations. We present a case of metastatic RCC in a 75-year-old woman, initially presenting with haematuria and vaginal pain. Workup further revealed a renal tumor and a vaginal mass. A nephrectomy and local vaginal excision were performed, leading to the diagnosis of metastatic RCC. This case illustrate the variability in RCC presentation. Also, because vaginal clear cell carcinoma is rare, all such lesions should be considered potentially renal in origin.     

Brain metastasis from renal cell carcinoma

BackgroundPatients with brain metastasis (BM) from renal cell carcinoma (RCC) have a poorly known prognosis due to the rarity of this disease. The aim of our study was to assess the outcome of patients with a BM due to RCC, and to determine the predictive factors for survival.MethodsConsecutive patients who underwent treatment between 1997 and 2012 were identified retrospectively from a database (n = 28, median age of 57.8 years, sex ratio M/F: 3.7). Main criteria collected concerned survival time. Other data collected were relative to initial histology, clinical findings at the time of BM diagnosis (diagnosis circumstances, KPS), radiological findings and BM characteristics (number, size and localization), treatment of BM (including surgery, stereotactic radiosurgery [SRS], systemic treatments, whole brain radiotherapy [WBRT]) and the outcome of surgery if performed. Statistical analysis of survival was performed using the Kaplan-Meier method.ResultsMedian survival was 13.3 months, 1-year survival was 60.2%, 2-year survival was 16.4%. Univariate analysis showed the existence of intracranial hypertension (P = 0.01), other systemic metastasis (P = 0.049), the absence of deep metastasis (P = 0.03) which are all linked to shorter survival. Age, KPS, initial histology of RCC, number, size, localization, and hemorrhage in BM were not correlated to survival. The median survival in the surgical resection group was 25.3 months versus 8.6 months (P = 0.02). The main criteria for the selection of the surgical group were a single BM (P = 0.04), and superficial metastasis (P = 0.02).ConclusionsThree predictive factors for longer survival in BMRCC were the absence of intracranial hypertension, the absence of acute metastasis and the absence of extracranial metastasis. Surgical removal, when possible, seems to benefit patient survival.