Late metastasis of renal cell carcinoma to the submaxillary gland 10 years after radical nephrectomy

Renal cell carcinoma metastasis to the submaxillary gland after tumor nephrectomy has not been previously recorded in the literature. Most reported cases have involved the parotid gland. We report in this article the first case of solitary submaxillary gland metastasis from clear cell renal cell carcinoma in an 83-year-old man who presented 10 years after primary treatment. The submaxillary gland was excised with preservation of the facial nerve.     

Late solitary metastasis of renal cell carcinoma to the submandibular gland

Metastatic renal cell carcinoma to the head and neck is rare. Most reported cases of metastases to the head and neck involve the thyroid and parotid glands. Metastasis to other salivary glands is exceedingly rare. This report describes a case of a solitary metastasis of renal cell carcinoma to the submandibular gland 9 years after nephrectomy. To the authors' knowledge, this is the first case successfully diagnosed preoperatively using a combination of fine-needle aspiration and clinical history. The patient subsequently underwent a submandibular gland resection with preservation of the facial nerve branches. For the 3 years since resection of the submandibular gland, the patient has been free of disease.     

Rare presentation of renal cell carcinoma: Solitary sternal metastasis

Renal cell carcinoma (RCC) may present as metastatic disease. However, RCC with solitary sternal metastasis is rare. We report a rare case of RCC with synchronous solitary sternal metastasis. The patient underwent radical nephrectomy, sternal tumour resection and reconstruction as a one‐stage procedure. The role of open sternal biopsy is also described. Review of the literature was carried out and a reasonably lengthy survival was observed. We concluded that radical surgical resection and reconstruction may offer the best chance of survival in managing RCC with solitary sternal metastasis in renal cell carcinoma.     

Renal artery pseudoaneurysm after laparoscopic partial nephrectomy for renal cell carcinoma in a solitary kidney

Abstract Renal artery pseudoaneurysms are a well‐documented complication following trauma or percutaneous urological procedures, but are rare after partial nephrectomy. We present the case of a 34‐year‐old woman who, after undergoing a left nephrectomy in childhood due to Wilms’ tumor, had a pseudoaneurysm in a solitary kidney after laparoscopic right partial nephrectomy with extraperitoneal approach for a renal cell carcinoma. The segmental renal artery feeding the pseudoaneurysm was embolized with coils without significant loss of residual renal function.     

Solitary Pancreatic Metastasis from Renal Cell Carcinoma Concomitant with Early Gastric Cancer 17 Years After Nephrectomy: Report of a Case

The pancreas is an uncommon site for metastasis from renal cell carcinoma. We report the case of a 70-year-old man in whom a solitary pancreatic metastasis from renal cell carcinoma, found 17 years after nephrectomy, was successfully resected, combined with gastrectomy for early gastric cancer. We also discuss the relevant literature, including all the reports of pancreatic metastasis from renal cell carcinoma found in Medline. More than half the cases, like ours, were asymptomatic. A good prognosis can be expected once the pancreatic metastatic lesions are surgically excised, especially if it is a solitary metastasis. Therefore, surgical resection of pancreatic metastases is recommended to achieve the best chance of long-term survival. Special attention must be paid to the possibility of recurrence, even more than 10 years after nephrectomy for renal cell carcinoma, and imaging modalities should be part of the routine follow-up to detect metastases at an early stage.     

Solitary metastasis of renal cell carcinoma to the contralateral adrenal gland 22 years after nephrectomy

A case of solitary metastasis to the contralateral adrenal 22 years after radical nephrectomy for renal cell carcinoma (RCC) is described. This case highlights the variable behavior of RCC, the tendency for adrenal metastasis, and the potential for prolonged survival after resection of late solitary metastases.     

Diagnosis by aspiration biopsy of lung metastasis of renal cell carcinoma 24 years after nephrectomy

A case of solitary pulmonary metastasis of renal cell carcinoma, diagnosed by fine needle aspiration biopsy 24 years after nephrectomy, is presented. The increasingly prominent role of fine needle aspiration cytology in the metastasis categorization of renal cell carcinoma is discussed.     

Renal cell carcinoma with solitary metachronous metastasis to the urinary bladder

We report a case of renal cell carcinoma with solitary metachronous metastasis to the urinary bladder occurring 6 years after radical nephrectomy. The patient was treated with partial cystectomy and survived for 60 months. Other cases like this one were reviewed in published reports, and the 3-year survival rate for patients with this type of cancer with solitary metastasis to the urinary bladder was found to be 80%. The follow-up duration of our case was the longest in the published studies. We suggest that urinary bladder metastasis of renal cell carcinoma should be resected because no effective treatment for metastatic renal cell carcinoma is available. A good prognosis may be expected, especially in patients with solitary metastasis to the urinary bladder.     

Solitary brain metastasis from renal cell carcinoma 14 years after nephrectomy: a case report

We report a case of solitary brain metastasis from renal cell carcinoma (RCC) 14 years after nephrectomy. A 46-year-old female had sudden onset of headaches, aphasia, gait disturbance and right hemiparesis. A brain CT revealed a cystic tumor in the left parietal area, which was surgically removed completely. Microscopic appearances of the brain tumor were similar to those of the primary RCC. Positive immunoreaction for epithelial membrane antigen (EMA) and keratin confirmed the diagnosis of metastatic RCC. This is the second case of solitary brain metastasis from RCC occurring more than 10 years after nephrectomy.     

Solitary renal metastasis 23 years after extirpation of a bronchial adenoid cystic carcinoma

In a 47-year-old man left nephrectomy was performed in 1982 because of a solitary metastasis arising from a bronchial adenoid cystic carcinoma which had been extirpated 23 years previously, in 1959. Whole-body CT scanning one year after nephrectomy disclosed no local recurrence or further metastasis. The importance of long follow-up after surgery for adenoid cystic carcinoma is emphasized.     

Renal cell carcinoma with solitary contralateral adrenal metastasis

We report on 2 cases of renal cell carcinoma with solitary contralateral adrenal metastasis which was demonstrated six months and one year, respectively, after radical nephrectomy. Pulmonary metastases developed six months after adrenalectomy in 1 patient; the other patient is alive without any evidence of disease twenty-two months after adrenalectomy.     

Laparoscopic excision of a solitary renal cell carcinoma metastasis to the contralateral perirenal adipose tissue

Metastasis of renal cell carcinoma to the contralateral perirenal fat is a very rare occurrence. We report a case of a synchronous, solitary perirenal metastasis excised laparoscopically 2 years after initial, open radical nephrectomy.     

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.     

Renal cell carcinoma with solitary metastases to pericardium

Approximately 1 to 3 per cent of patients presenting with metastatic renal cell carcinoma will have a solitary metastatic lesion. An unusual case of solitary metastasis is described. Treatment consisted of nephrectomy and radiation therapy to the pericardium.     

Renal adenocarcinoma with solitary metastasis to the contralateral adrenal gland: report of 2 cases and review of the literature

We report 2 rare cases of renal adenocarcinoma with solitary metastasis to the contralateral adrenal gland, 1 recognized synchronously with the primary neoplasm and 1 found 15 years after nephrectomy. The latter case represents the longest reported interval between nephrectomy and treatment of a solitary contralateral adrenal metastasis of renal adenocarcinoma. Distinction of these metastatic tumors from primary adrenocortical carcinoma was facilitated by immunohistochemical markers. Twelve other reported cases of renal adenocarcinoma with solitary contralateral adrenal metastasis support aggressive surgical management of this lesion.     

Solitary liver metastasis of chromophobe renal cell carcinoma 20 years after nephrectomy treated by hepatic resection

A small proportion of patients with metastatic renal cell carcinoma have operable liver metastases, as there is often multiple dissemination within the liver and to other organs. We present a case of a solitary liver metastasis found incidentally 20 years after radical nephrectomy for a chromophobe renal cell carcinoma. The patient underwent a liver resection with tumor-free margins and recovered uneventfully. Time will tell if this was oncologically successful.     

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.     

Solitary, late metastatic recurrence of renal cell carcinoma: Two extraordinary cases

Late recurrence of renal cell carcinoma (RCC) has been well documented in the literature. We present two extraordinary cases of solitary, late metastatic recurrence of RCC. The first is a case of a solitary, adrenal metastasis excised 38 years after nephrectomy and the second is a case in which two solitary metastatic deposits were resected 14 and 26 years after excision of the primary tumor. In each of these patients the solitary metastases were initially believed to be primary tumors at other sites; however, on histological examination they were found to be metastatic RCC recurrences. In patients with a previous history of RCC presenting with apparently new solitary lesions, metastatic RCC must first be excluded.     

Bladder metastasis of renal cell carcinoma : report of a case

A 65-year-old man presented with gross hematuria in 2004. Computed tomography (CT) showed a left renal mass, and he underwent laparoscopic radical nephrectomy. Pathological diagnosis was clear cell carcinoma (pT2N0M0, G2＞G3). Four years later, a right adrenal tumor was disclosed by follow-up CT. Then laparoscopic adrenectomy was performed. Histology showed metastasis of the renal clear cell carcinoma. In 2009, he noticed gross hematuria, and cystoscopy revealed a 2cm solitary, non-papillary tumor at the anterior wall of the bladder. At the same time, small solitary liver metastasis (6 mm) was observed on abdominal CT. Transurethral resection of the bladder tumor and resection of liver tumor was performed, and pathological diagnosis was clear cell carcinoma both in vesical and hepatic masses. Nine months after the last surgery, he is living with no obvious tumor recurrence. To our knowledge this case is the 34th case of bladder metastasis from renal cell carcinoma in the Japanese literature. We reviewed literature and discuss the clinical features of bladder metastasis of renal cell carcinoma.     

Isolated Late Metastasis of a Renal Cell Cancer Treated by Radical Distal Pancreatectomy

A 53–year-old man underwent right nephrectomy for a locally advanced renal cell carcinoma with concomitant resection of a solitary metastasis in the right lung. Ten years later, he presented with haematochezia caused by a tumour in the tail of pancreas, invading the transverse colon and the greater curvature of the stomach. The tumour was radically resected, and histological examination revealed a solitary metastasis of the previous renal cell carcinoma. This case illustrates a rare indication for pancreatic resection because of pancreatic metastasis.