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Yang W, Cai Z, Nie P, Yuan T, Zhou H, Du Q, Qiu S, Zhang J, Yang L. Case report and literature review: Small bowel intussusception due to solitary metachronous metastasis from renal cell carcinoma. Front Oncol 2022; 12:1072485. [PMID: 36601471 PMCID: PMC9806257 DOI: 10.3389/fonc.2022.1072485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Solitary metachronous small bowel metastasis from renal cell carcinoma (RCC) is rare. In contrast to idiopathic intussusception frequently occurring in children, adult intussusception is fairly uncommon and usually indicates a malignancy. Case presentation We presented an 84-year-old man with small bowel intussusception and obstruction due to a solitary metachronous metastasis from RCC. Computed tomography with intravenous contrast revealed small bowel obstruction and a 4 × 4 cm intraluminal soft-tissue mass with moderate enhancement. During urgent exploratory laparotomy, a pedunculated tumor of the distal ileum was found to be the lead point of intussusception. Hence, reduction of the intestinal invagination and segmental resection of the ileum with functional end-to-end anastomosis were performed. Histological examination finally confirmed the diagnosis. The postoperative recovery was uneventful. The patient was discharged without any complications on postoperative day 6. Conclusion The case report highlights the rarity of solitary metachronous small bowel metastases from RCC and suggests that life-long follow-up of RCC patients is critical due to its unpredictable behavior and the possibility of a long period of dormancy. Complete surgical resection remains the mainstay treatment for such patients.
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Affiliation(s)
- Wenming Yang
- Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Zhaolun Cai
- Gastric Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Pan Nie
- Department of Gastrointestinal Surgery, The Third People’s Hospital of Chengdu, Chengdu, China
| | - Tao Yuan
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Hang Zhou
- Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Du
- Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Siyuan Qiu
- Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jianhao Zhang
- Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Lie Yang
- Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China,*Correspondence: Lie Yang,
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Psutka SP, Master VA. Role of metastasis-directed treatment in kidney cancer. Cancer 2018; 124:3641-3655. [PMID: 29689599 DOI: 10.1002/cncr.31341] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 02/05/2018] [Accepted: 02/09/2018] [Indexed: 12/12/2022]
Abstract
Despite the rapid elaboration of multiple, novel systemic agents introduced for metastatic renal cell carcinoma (mRCC) in recent years, a durable complete response remains elusive with systemic therapy alone. Definitive treatment of the metastatic deposit remains the sole potentially curative option and is a cornerstone of mRCC therapy, offering potential for both local control and palliation of tumor-related symptoms. In this review, the evidence supporting the definitive treatment of mRCC is examined and summarized, including the use of surgical metastasectomy, thermal ablation, radiotherapy, and other minimally invasive options. Multimodal approaches, including the combination of metastasectomy with novel systemic agents, are discussed. Finally, the authors review considerations for patient selection for this type of therapy and summarize available risk-stratification tools that may help guide shared decision making.
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Affiliation(s)
- Sarah P Psutka
- Division of Urology, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois.,Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Viraj A Master
- Department of Urology, Winship Cancer Institute, Emory University, Atlanta, Georgia
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Zhang F, Zhao G, Wu P, An Q, Yang Y, Chen X, Wang J, Wei D. Asynchronous abdominal wall and sigmoid metastases in clear cell renal cell carcinoma: A case report and literature review. Asian J Urol 2018; 6:210-214. [PMID: 31061809 PMCID: PMC6488679 DOI: 10.1016/j.ajur.2018.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 04/04/2017] [Accepted: 05/04/2017] [Indexed: 02/08/2023] Open
Abstract
Sigmoid metastasis of renal cell carcinoma (RCC) is very rare. Herein we report a case of pathologically proven asynchronous abdominal wall and sigmoid metastases after a right nephrectomy. An 84-year-old man underwent right radical nephrectomy for clear cell renal cell carcinoma (ccRCC) 13 years ago. Solitary contralateral abdominal wall metastasis was found for left abdominal mass 9 years after nephrectomy. The man experienced melena underwent resection of sigmoid colon tumor in February, 2016. The postoperative pathological examinations revealed that the tumors were metastases of ccRCC. Recurrence more than 5 years after nephrectomy has been accepted as late recurrence by the majority of urologists now. Late recurrence is one of the specific biological behaviors of RCC. Asynchronous late recurrence of abdominal wall and sigmoid metastases in ccRCC has not been reported before. When patients have sigmoid mass after nephrectomy for RCC, doctors may consider the possibility of late recurrence.
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Affiliation(s)
- Fangyuan Zhang
- Department of Urology, Beijing Hospital, The Fifth Clinical Medical School of Peking University, National Center of Gerontology, Beijing, China
| | - Gang Zhao
- Department of General Surgery, Beijing Hospital, The Fifth Clinical Medical School of Peking University, National Center of Gerontology, Beijing, China
| | - Pengjie Wu
- Department of Urology, Beijing Hospital, The Fifth Clinical Medical School of Peking University, National Center of Gerontology, Beijing, China
| | - Qi An
- Department of General Surgery, Beijing Hospital, The Fifth Clinical Medical School of Peking University, National Center of Gerontology, Beijing, China
| | - Yang Yang
- Department of General Surgery, Beijing Hospital, The Fifth Clinical Medical School of Peking University, National Center of Gerontology, Beijing, China
| | - Xin Chen
- Department of Urology, Beijing Hospital, The Fifth Clinical Medical School of Peking University, National Center of Gerontology, Beijing, China
| | - Jianye Wang
- Department of Urology, Beijing Hospital, The Fifth Clinical Medical School of Peking University, National Center of Gerontology, Beijing, China
| | - Dong Wei
- Department of Urology, Beijing Hospital, The Fifth Clinical Medical School of Peking University, National Center of Gerontology, Beijing, China
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Choi SY, Yoo S, You D, Jeong IG, Song C, Hong B, Hong JH, Ahn H, Kim CS. Prognostic Factors for Survival of Patients With Synchronous or Metachronous Brain Metastasis of Renal Cell Carcinoma. Clin Genitourin Cancer 2017; 15:717-723. [PMID: 28552571 DOI: 10.1016/j.clgc.2017.05.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 04/17/2017] [Accepted: 05/01/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION We evaluated the oncological outcomes of synchronous or metachronous brain metastasis (BM) of metastatic renal cell carcinoma (RCC) according to clinicopathologic factors. PATIENTS AND METHODS Patients with metastatic RCC (n = 93) with synchronous and metachronous BM were retrospectively identified. We analyzed patients and tumor characteristics, treatment methods, prognostic factors, BM progression, and overall survival (OS). RESULTS Seventy-six patients (81.7%) received local therapy (stereotactic radiosurgery [60.2%], radiation therapy [22.6%], and neurosurgery [10.8%]), and 54 patients (58.1%) were treated with systemic medical therapy. In multivariable analysis, poor Memorial Sloan-Kettering Cancer Center (MSKCC) risk (hazard ratio [HR] 3.672; 95% confidence interval [CI], 1.441-9.36; P = .0064), sarcomatoid component (HR 4.264; 95% CI, 2.062-8.820; P = .0001), and multiple BMs (HR 2.838; 95% CI, 1.690-4.767; P = .0001) were prognostic indicators of a poorer OS outcome. Local (HR 0.436; 95% CI, 0.237-0.802; P = .0076) and systemic treatment (HR 0.322; 95% CI, 0.190-0.548; P < .0001) were independent factors for a better OS. Although OS from initial RCC diagnosis in patients with metachronous BM was better than that for patients with synchronous BM, there were no differences found between synchronous and metachronous patients in terms of BM progression and OS after the diagnosis of BM. CONCLUSIONS Poor MSKCC risk, sarcomatoid component of histology, and multiple BMs are prognostic indicators for poor OS in patients with BM from metastatic RCC. Systemic and/or local treatment improves the OS. Because the type of BM, synchronous or metachronous, does not influence BM progression or the OS outcome, routine evaluation for BM is not recommended.
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Affiliation(s)
- Se Young Choi
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sangjun Yoo
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dalsan You
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - In Gab Jeong
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Cheryn Song
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bumsik Hong
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jun Hyuk Hong
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hanjong Ahn
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Choung-Soo Kim
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Du Y, Pahernik S, Hadaschik B, Teber D, Duensing S, Jäger D, Hohenfellner M, Grüllich C. Survival and prognostic factors of patients with renal cell cancer with bone metastasis in the era of targeted therapy: A single-institution analysis. Urol Oncol 2016; 34:433.e1-8. [DOI: 10.1016/j.urolonc.2016.05.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/17/2016] [Accepted: 05/16/2016] [Indexed: 12/23/2022]
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Du Y, Pahernik S, Hadaschik B, Teber D, Duensing S, Jäger D, Hohenfellner M, Grüllich C. Impact of resection and systemic therapy on the survival of patients with brain metastasis of metastatic renal cell carcinoma. J Neurooncol 2016; 130:221-228. [DOI: 10.1007/s11060-016-2238-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 08/09/2016] [Indexed: 12/22/2022]
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