Metastatic renal cell carcinoma presenting as multiple pleural tumours |
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Authors: | Ohnishi Hiroshi Abe Masahiro Hamada Hironobu Yokoyama Akihito Hirayama Takeru Ito Ryoji Nishimura Kazutaka Higaki Jitsuo |
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Affiliation: | Second Department of Internal Medicine, Ehime University School of Medicine, Onsen-gun, Ehime, Japan. honi@hiroshima-u.ac.jp |
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Abstract: | A 66-year-old man was admitted with dyspnoea. Chest X-ray and chest computed tomography (CT) demonstrated a left-sided pleural effusion and multiple tumours, suggesting malignant mesothelioma in the left pleural space, but there were no pulmonary lesions. However, abdominal CT revealed a right renal tumour. An ultrasonography-guided needle biopsy of the pleural mass provided evidence of metastatic renal cell carcinoma (RCC). The pleural lesions dramatically decreased in size following right radical nephrectomy and subsequent interferon-alpha treatment. While the thorax is a frequently affected site of RCC, sole pleural metastases are rare and are often secondary to lung involvement. Batson's plexus, a network of vertebral valve-less veins with multiple connections, is likely responsible for the contralateral pleural metastases of RCC. |
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Keywords: | mesothelioma metastasis needle biopsy pleural effusion renal cell carcinoma |
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