Bilateral renal cell carcinoma with metastasis to thyroid

A case of bilateral synchronous renal cell carcinomas with metastases to the regional lymph nodes and later to the thyroid gland was treated with aggressive surgical extirpation and adjuvant gamma interferon. The patient continues to have an excellent performance status sixteen months after initial diagnosis despite a large tumor burden at presentation.     

A resected case of renal cell carcinoma with metastasis to pancreas]

We report a case of renal cell carcinoma with metastasis to the pancreas, treated by radical nephrectomy and total pancreatectomy. A 56-year-old man visited our hospital because of macrohematuria and right low backache. An intravenous pyelography, ultrasonography and a CT scan of the abdomen revealed right renal tumor at the upper portion, about 11 cm in diameter, but no abnormal findings of the pancreas. Aortic and celiac angiograms demonstrated multifocal lesions, 1 or 2 cm in size, compatible with a metastatic tumor in the region of the pancreas. The patient underwent right radical nephrectomy and open biopsy of the pancreas. The right renal tumor was histologically revealed to be renal cell carcinoma without nodal or venous extension. Histological examination of the pancreas biopsy specimen confirmed it to be a renal cell carcinoma metastatic to the pancreas. Therefore, he underwent total pancreatectomy 1 month after the previous surgery. Three months after the second surgery, a CT scan of the brain revealed metastasis to the pituitary gland. He is still under therapy.     

Intracardiac renal cell carcinoma metastasis

Cardiac involvement by intravascular protruding renal cell carcinoma is a well-recognised phenomenon. It most commonly occurs through inferior vena cava extension. Here, we report a case of a lower lobar lung metastasis from renal cell carcinoma involving the left atrium via the inferior pulmonary vein in a patient presenting with von Hippel-Lindau disease. Complete surgical resection was achieved under cardiopulmonary bypass.     

Solitary metastasis of renal cell carcinoma to urethra

A case report of a solitary metastasis to the urethra from previously resected renal cell carcinoma is reported. The patient presented with total gross painless hematuria. We believe this is the first such case to be reported.     

A solitary and synchronous metastasis of renal cell carcinoma to the bladder

We report a case of renal cell carcinoma with solitary metastasis to the bladder which occurred and was treated synchronously. The mode of spread and possible treatment modalities are discussed with relevant information from the literature.     

Bone pulsating metastasis due to renal cell carcinoma

Pulsation on the bone cortex surface is a rare condition. Pulsative palpation of the superficial-located bone tumors can be misperceived as an aneurysm. Fifty-eight-year-old man is presented with pulsating bone mass in his proximal tibia. During angiographic examination, hypervascular masses were diagnosed both at right kidney and at right proximal tibia. Renal cell carcinoma was diagnosed after abdominal CT scan. Proximal tibia biopsy was complicated with projectile bleeding.     

Airway obstruction due to metastatic renal cell carcinoma to the tongue.

Metastatic lesions in the tongue are extremely rare. Renal cell carcinoma is the most frequent kidney neoplasm, with a high tendency to metastasize. It is the third most frequent neoplasm to metastasize to the head and neck region. We report a case of a rapidly enlarging tongue metastasis causing airway obstruction in a patient with widespread disease. Local excision was the elected treatment to provide palliation of the obstruction.     

肾癌骨转移的治疗

目的　探讨肾癌骨转移的临床特点及治疗效果。　方法　对 2 6例肾癌骨转移患者先期行辅助性肾切除后 ,根据骨转移情况不同分三组进行治疗。第 1组 :骨孤立转移灶 12例 ,行彻底切除 ;第 2组 :多发骨转移有潜在性病理骨折或截瘫危险患者 8例 ,选择性行骨病灶肿瘤囊内刮除或椎板减压 固定术 ;第 3组 :多发骨转移患者 6例 ,骨转移病灶未行手术治疗。 3组均接受系统性免疫治疗。随访时间 4～ 6 6个月 ,平均 (45 .8± 11.7)个月 ,分析三组临床资料及治疗效果。　结果　第 1组 1、3、5年生存率分别为 83%、75 %、5 8% ,平均生存期 (48.5± 6 .7)个月、半数生存期 (37± 13.2 )个月 ,均高于 2、3组。生存曲线比较 ,1组与 2、3组差别有显著性意义 (P <0 .0 5 ) ,2、3组之间比较差别无显著性意义 (P >0 .0 5 )。第 3组中出现病理性骨折和截瘫各 1例。　结论　肾癌骨转移患者除实施辅助性肾切除 辅助性治疗外 ,有指征的针对骨转移病灶进行手术可提高肾癌骨转移患者的生存期或生存质量。     

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.     

A case of solitary metastasis of renal cell carcinoma to the thyroid gland

A case of solitary metastasis of renal cell carcinoma to the thyroid gland is reported. A 63-year-old-woman had been found to have an abnormal mass in the neck since April, 1986. She had a past history of right nephrectomy owing to right renal tumor 6 months earlier. Histological examination of the renal tumor revealed, common type, alveolar type, G1, INF alpha renal cell carcinoma. No metastasis was found on abdominal CT, chest tomography and bone scintigram at that time. Radical thyroidectomy was performed on June, 23, 1986. Histological examination by hematoxylin and eosin staining revealed metastasis of renal cell carcinoma, and immunohistochemical technique ruled out primary thyroid carcinoma. Postoperatively no other metastasis was found on head-chest-abdomen-CT, chest-tomography or bone scintigram. Therefore no particular adjuvant therapy was performed.     

Urethral metastasis from renal cell carcinoma

A case of metastasis to the prostatic urethra after transurethral resection of the prostate from a previously resected renal cell carcinoma (RCC) is reported here. Solitary urethral metastasis from RCC is extremely rare. Only four cases of urethral metastasis from RCC have been previously reported in the literature.     

Adrenal metastasis in renal cell carcinoma

Adrenal metastases in renal cell carcinoma are not uncommon in autopsy series. An incidence of 19 per cent has been reported. The diagnosis of adrenal metastases clinically is rare. Two cases, one of an ipsilateral metastasis and one of a contralateral metastasis, are presented, and the literature is reviewed.     

Penile metastasis of renal cell carcinoma

The tumour dissemination to penis from renal cell carcinoma is a rare occurrence; generally, it is seen in advanced stages of the disease, such that occurred in our patient that indicated a poor prognosis. A lesion node, high, painless, the size middle, located in the side right to penis, at long term free of symptoms associated was found. The histological examination of the specimen after cold biopsy demonstrated a metastasis from renal carcinoma.     

Prostatic metastasis of renal cell carcinoma

A 71-year-old man underwent a radical nephrectomy for right renal cell carcinoma in April, 2005. Pathological findings revealed clear cell carcinoma, G3＞G2, pT3a. Three years later, he underwent a craniotomy for tumor resection of solitary brain metastasis. In October, 2008, he came to our hospital because of urinary retention. Benign prostate hypertrophy was diagnosed by ultrasonography and digital rectal examination. Serum prostate specific antigen level was 2.55 ng/dl. While he was treated with oral α 1-blocker initially, a urethral catheter was inserted in December, 2009. Because of frequent obstruction of the catheter by hematuria, transureathral prostectomy was performed. Pathological findings revealed prostatic metastasis of renal cell carcinoma. Metastasis of renal cell carcinoma to the prostate is rare, and only 7 cases including the present case have been reported.