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Sanchez Teran AI, Martínez Zamorano M, Trujillo Ortíz JA, Cerna Arriaga J. Renal cell carcinoma (RCC) spreading to the larynx: an unusual condition. BMJ Case Rep 2024; 17:e255459. [PMID: 38272511 PMCID: PMC10826486 DOI: 10.1136/bcr-2023-255459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
A man in his mid-70s, heavy smoker with chronic alcohol consumption and a chronic exposure to insecticides and burning of crop residues was referred to the surgical oncology department because of a 4-month onset of hoarseness, dyspnoea and laryngeal stridor. He had a history of left nephrectomy due to Fuhrman IV clear cell renal cancer 2 years ago. The patient underwent a bronchoscopy which identified a deforming tumour of the left vallecula, occlusion of 90% of the lumen and did not allow a safe biopsy. Following discussion between the oncological team, total laryngectomy and bilateral neck dissection of levels II, III, IV and V were performed, finding a transglottic tumour of approximately 4×3 cm with extension to the right anterolateral thyroid cartilage. The pathology report described metastatic RCC. The patient recovered well postoperatively and started systemic therapy with a vascular endothelial growth factor receptors inhibitor.
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Bandoh N, Kubota A, Takeda R, Sakaue S, Goto T, Baba S, Hashiba N, Kato Y, Nishihara H. Renal Cell Carcinoma Metastasizing to the Cricoid Cartilage Presenting With Subglottic Stenosis: A Case Report and Literature Review. EAR, NOSE & THROAT JOURNAL 2023:1455613231177188. [PMID: 37231666 DOI: 10.1177/01455613231177188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
A 72-year-old Japanese man with a 4-month history of hoarseness and 1-week history of difficulty breathing was admitted to our department. He underwent right total nephrectomy for primary clear cell-type renal cell carcinoma (RCC) 6 years ago and left partial nephrectomy for the metastasis 4 years ago. Flexible laryngeal fiberscope examination revealed bilateral subglottic stenosis without obvious mucosal lesions. Enhanced computerized tomography (CT) scan of the neck revealed that the cricoid cartilage had become bilaterally expansive and tumorous lesion exhibiting enhancement. We performed tracheostomy on the appointed day and biopsied the tumor in the cricoid cartilage via the skin incision. Results of histologic and immunohistologic examinations for AE1/AE3, CD10, and vimentin positivity were consistent with clear cell-type RCC. Chest and abdomen CT scans revealed a few tiny metastases in the upper lobe of the left lung but no recurrence in the abdomen. At 2 weeks from the day of tracheostomy, total laryngectomy was performed. Postoperatively, the patient was treated transorally with axitinib (10 mg/day) and as of 12 months he remains alive with unchanging lung metastasis. Next-generation sequencing of targeted regions using a surgical specimen from the tumor revealed a frameshift mutation in the von Hippel-Lindau gene (p.T124Hfs*35) and a missense mutation in the TP53 gene (p.H193R).
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Affiliation(s)
- Nobuyuki Bandoh
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
| | - Akinobu Kubota
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Ryuhei Takeda
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Shota Sakaue
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Takashi Goto
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
| | - Shogo Baba
- Department of Pathology, Hokuto Hospital, Obihiro, Hokkaido, Japan
| | - Natsumi Hashiba
- Department of Pathology, Hokuto Hospital, Obihiro, Hokkaido, Japan
| | - Yasutaka Kato
- Department of Pathology, Hokuto Hospital, Obihiro, Hokkaido, Japan
| | - Hiroshi Nishihara
- Keio Cancer Center, Keio University School of Medicine, Tokyo, Japan
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Haddad G, Sataloff RT, Hamdan AL. Laryngeal Metastatic Lesions: A Literature Review. J Voice 2022:S0892-1997(22)00170-9. [PMID: 35918235 DOI: 10.1016/j.jvoice.2022.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/10/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cancer ravages all aspects of a patient's life. In recent decades, there has been a substantial paradigm shift in the treatment of cancer with an emphasis on quality of life and patient comfort. Patients are treated holistically, a complex task given how multifaceted cancers are. Voice, a subtle indicator of patients' well-being is affected commonly by malignancies. One of the various ways by which voice is disturbed by non-laryngeal cancers is through metastasis to the larynx and adjacent areas. Metastasis to the larynx is rare but well-documented. If not diagnosed in a timely fashion, it can have devastating consequences on patients from life-threatening airway obstruction to progressive dysphonia that erodes their quality of life. Metastatic lesions of the larynx usually appear submucosal with intact overlying mucosa and are located most commonly in the supraglottis. Deep biopsies usually are needed for diagnosis, and management may entail endoscopic resection or other treatments. OBJECTIVES This paper reviews the literature to identify typical features of laryngeal metastatic lesions of the ten cancers that are among the most common worldwide, ie, skin, renal, breast, colorectal, lung, prostate, thyroid and liver. By summarizing their most prevalent locations in the larynx, type and appearance, the authors hope to aid physicians in their diagnostic process, particularly in cases in which laryngeal involvement is the first presenting sign of a malignancy.
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Affiliation(s)
- Ghassan Haddad
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Robert Thayer Sataloff
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Abdul-Latif Hamdan
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon.
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Nisi M, Izzetti R, Graziani F, Gabriele M. Renal Cell Carcinoma Metastases to the Oral Cavity: Report of 2 Cases and Review of Literature. J Oral Maxillofac Surg 2020; 78:1557-1571. [PMID: 32386976 DOI: 10.1016/j.joms.2020.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/01/2020] [Accepted: 04/01/2020] [Indexed: 02/06/2023]
Abstract
The localization of renal cell carcinoma (RCC) metastases in the oral cavity has been reported, accounting for about 15% of patients with metastasizing renal disease. In this work, we report 2 cases of oral metastases of renal carcinoma and provide a review of the current literature on the occurrence of oral metastases of renal origin. The first patient (a 61-year-old man) presented with a tumefaction of the body of the tongue. The second patient (a 71-year-old man) showed a large mass localized in the buccal mucosa. In both patients, incisional biopsy was performed to better characterize the nature of the lesions. Histologic evaluation showed the metastatic origin of the 2 lesions, which were distant metastases of clear cell RCC. After systemic evaluation, a second surgical procedure was performed to obtain a wider resection of the mass to reduce the development of complications and improve the patients' quality-of-life. After the second surgical treatment, both patients showed an improvement in symptoms, and no further complications and/or signs of recurrence were detected. At present, 132 cases of oral metastases of RCC have been described in the literature. This article reviews and discusses the clinical, diagnostic, and pathologic features and the treatment options reported in the literature. Localization of renal metastases to the tongue was the most frequently described localization in the literature. In general, surgical treatment appears to be effective in controlling metastasis development and associated symptoms. Although relatively rare, renal metastases to the oral cavity should be taken into account when creating the differential diagnosis of oral lesions of unknown origin.
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Affiliation(s)
- Marco Nisi
- Assistant Professor, Department of Surgical Pathology, Medicine, Molecular and Critical Area, University of Pisa, Pisa, Italy.
| | - Rossana Izzetti
- PhD Student, Department of Surgical Pathology, Medicine, Molecular and Critical Area, University of Pisa, Pisa, Italy
| | - Filippo Graziani
- Full Professor, Department of Surgical Pathology, Medicine, Molecular and Critical Area, University of Pisa, Pisa, Italy
| | - Mario Gabriele
- Full Professor, Department of Surgical Pathology, Medicine, Molecular and Critical Area, University of Pisa, Pisa, Italy
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Badri M, Gader G, Bahri K, Zammel I. Skull metastasis revealing a renal tumor: A case report and review of the literature. Int J Surg Case Rep 2018; 43:56-60. [PMID: 29453166 PMCID: PMC5849813 DOI: 10.1016/j.ijscr.2018.01.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 01/16/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Renal cell carcinomas represent 85% of malignant renal tumors. Typically, the tumor remains asymptomatic a long time before the appearance of urologic clinical signs. In some cases, metastasis can precede the manifestations of the primary tumor. Different sites are potential metastatic localizations for renal tumors, including skull metastases who represent a very rare location. CASE DESCRIPTION We report the case of a 65-year-old man presented after the appearance of a skull mass. This tumefaction developed and had progressively grown up during 9 months. Neurological examination was normal. Brain imaging showed a soft tissue lesion in the left parietal bone with marked osteolysis. Peroperative was found a huge oval-shape hemorrhagic and firm mass associated with scalp invasion and bone destruction that was totally resected. Histopathology revealed renal cell carcinoma (RCC). Pelvic and abdominal CT scan was performed, revealing a large mass on the left kidney with irregular contours and poor definition. The patient was then transferred to urology where he underwent nephrectomy. The patient went then through adjuvant chemotherapy. Clinical and radiological follow up of 12 months did not bring to light tumor recurrence. CONCLUSIONS Although metastases to the head and neck occur infrequently, they should be considered when evaluating any unusual subcutaneous mass in the head and neck. RCC should not be discounted when sites as unlikely as the calvaria are evaluated. Treatment of metastatic renal cell carcinoma is complex, and the optimal regimen for achieving a lasting response without severe toxicity has not yet been defined.
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Affiliation(s)
- Mohamed Badri
- El Manar-Tunis University, Faculty of medicine of Tunis, Burns and Trauma Center, Department of Neurosurgery, Ben Arous, Tunisia.
| | - Ghassen Gader
- El Manar-Tunis University, Faculty of medicine of Tunis, Burns and Trauma Center, Department of Neurosurgery, Ben Arous, Tunisia.
| | - Kamel Bahri
- El Manar-Tunis University, Faculty of medicine of Tunis, Burns and Trauma Center, Department of Neurosurgery, Ben Arous, Tunisia.
| | - Ihsen Zammel
- El Manar-Tunis University, Faculty of medicine of Tunis, Burns and Trauma Center, Department of Neurosurgery, Ben Arous, Tunisia.
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Massaccesi M, Morganti AG, Serafini G, Di Lallo A, Deodato F, Picardi V, Scambia G. Late Tonsil Metastases from Renal Cell Cancer: A Case Report. TUMORI JOURNAL 2018; 95:521-4. [DOI: 10.1177/030089160909500420] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The occurrence of renal carcinoma metastasis to the head and neck region is extremely rare. Some authors have reported metastasis of renal cell carcinoma to the parotid glands, nose and paranasal sinus, tongue, larynx, thyroid and palatine tonsil. In this report we describe a rare case of renal cell cancer metastasized to the right tonsil in a 76-year-old man with previously diagnosed bone and lung metastases. To the best of our knowledge this is the first documented example of radiotherapy treatment in this type of presentation. Radiotherapy was effective in treating the lesion with satisfactory functional results.
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Affiliation(s)
- Mariangela Massaccesi
- Oncology Department, John Paul II Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso
| | - Alessio G Morganti
- Oncology Department, John Paul II Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso
| | | | | | - Francesco Deodato
- Oncology Department, John Paul II Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso
| | - Vincenzo Picardi
- Oncology Department, John Paul II Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso
| | - Giovanni Scambia
- Oncology Department, John Paul II Center for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso
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Suffee T, Derder M, Quilichini J, Dezamis E, Lantieri L. Calvarial metastasis of renal cell carcinoma. BMJ Support Palliat Care 2017; 8:436-438. [DOI: 10.1136/bmjspcare-2016-001216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 11/14/2016] [Accepted: 01/17/2017] [Indexed: 11/03/2022]
Abstract
The calvarium is an extremely unusual site of metastasis of renal cell carcinoma. We report a 62-year-old man who was enrolled for palliative medical management for an exophytic calvarial metastasis. His quality of life was greatly compromised with everyday local care and bandages due to recurrent events of infection and bleeding, limiting his social life. Surgical palliative surgery was carried out to improve the patient's quality of life. After tumour resection, the resultant defects of the calvarium and the scalp were covered by a muscular latissimus dorsi free flap and a fascia lata graft as dural substitute. There was no evidence of local recurrence or distant metastasis during the 3 years follow-up. Consequently, resection of solitary metastasis in the early stage is the treatment of choice with a chance to cure the metastasis and avoid associated morbidity that may occur if the lesion is left untreated.
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Rossini M, Bolzoni A, Piazza C, Peretti G. Renal Cell Carcinoma Metastatic to the Larynx. Otolaryngol Head Neck Surg 2016; 131:1029-30. [PMID: 15577815 DOI: 10.1016/j.otohns.2004.03.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Hassona Y, Hughes C, Prime SS. Metastatic tumours of the tongue. Oral Oncol 2011; 47:308-11. [PMID: 21354854 DOI: 10.1016/j.oraloncology.2011.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Revised: 01/27/2011] [Accepted: 01/30/2011] [Indexed: 11/16/2022]
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10
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Lingual metastasis as an initial presentation of renal cell carcinoma. Med Oncol 2010; 28:1389-94. [DOI: 10.1007/s12032-010-9596-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Accepted: 06/03/2010] [Indexed: 01/05/2023]
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Yeh HC, Yang SF, Ke HL, Lee KS, Huang CH, Wu WJ. Renal cell carcinoma presenting with skull metastasis: a case report and literature review. Kaohsiung J Med Sci 2007; 23:475-9. [PMID: 17766217 DOI: 10.1016/s1607-551x(08)70056-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
The occurrence of metastasis to the head and neck region in renal cell carcinoma is extremely rare. An 80-year-old man presented with a soft nodule in the left parietal calvarium and was admitted to our hospital. Biopsy of the nodule showed nests of clear tumor cells, suggesting metastatic renal cell carcinoma. Computed tomography of the abdomen revealed a well-defined hypervascular tumor, measuring around 7 x 7 x 8 cm, exophytic from the lower pole of the right kidney. Since there were no other systemic metastases, right nephrectomy and complete resection of the skull lesion were performed. No adjunctive therapy was given postoperatively. After 22 months of follow-up, the patient was well and without evidence of disease.
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Affiliation(s)
- Hsin-Chih Yeh
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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12
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Marioni G, Gaio E, Poletti A, Derosas F, Staffieri A. Uncommon metastatic site of renal adenocarcinoma: the oral tongue. Acta Otolaryngol 2004; 124:197-201. [PMID: 15072424 DOI: 10.1080/00016480310016929] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Primary tumours metastasizing to the tongue are very unusual and only anecdotal cases have been reported. An exhaustive literature review covering the period from 1970 onwards disclosed only 22 cases of renal adenocarcinoma metastasizing to the tongue. We report the case of an 87-year-old female patient with oral tongue, lung, liver, thyroid gland, pancreas and renal adenocarcinoma metastases. She had undergone contralateral nephrectomy for clear cell carcinoma 10 years before diagnosis of the metastases. The tongue lesion was surgically removed under local anaesthesia. Tongue metastasis of renal adenocarcinoma is usually a manifestation of widespread disease. The prognosis for patients with lingual metastasis of renal adenocarcinoma is poor, the mean interval from diagnosis of tongue metastasis to death being 5.8 months. In our patient, metastatic involvement of the tongue was detected approximately 5 months before death. Treatment of renal adenocarcinoma metastasis to the tongue is usually palliative and aims to provide patient comfort by means of pain relief and prevention of bleeding and infection. Surgical excision is recommended as the primary treatment, with emphasis on preservation of tongue structure and function. Recent data regarding immunotherapy or immunochemotherapy for metastatic renal adenocarcinoma are encouraging.
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Affiliation(s)
- Gino Marioni
- Department of Otolaryngology-Head and Neck Surgery, University of Padua, Italy.
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Yoskovitch A, Nguyen LH, Sadeghi N, Auger M. Renal cell carcinoma presenting as a mandibular mass. Otolaryngol Head Neck Surg 2001; 125:654-5. [PMID: 11743472 DOI: 10.1067/mhn.2001.120433] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- A Yoskovitch
- Department of Otolaryngology-Head and Neck Surgery, Sir Mortimer B. Davis-Jewish General Hospital, 3755 Cote Sainte Catherine Road, Suite E-209, Montreal, Quebec, Canada H3T 1E2
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