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Abera MT, Seman YS, Mohammed HY, Abrar FN, Mikru AM, Mersha MK. Pancreatic neuroendocrine tumor with solitary splenic metastasis and synchronous renal cell carcinoma: A rare case report. Radiol Case Rep 2024; 19:2760-2766. [PMID: 38680748 PMCID: PMC11046048 DOI: 10.1016/j.radcr.2024.03.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 03/31/2024] [Indexed: 05/01/2024] Open
Abstract
Synchronous pancreatic neuroendocrine tumors and renal cell cancer are extremely rare. Von-Hipple-Landau syndrome is a major association. A 43-year-old male patient with left upper quadrant pain and significant weight loss was diagnosed with a synchronous pancreatic tail neuroendocrine tumor with solitary splenic metastasis and a clear-cell renal cell carcinoma of the left kidney. Sonography and a computed tomography scan of the abdomen showed a complex exophytic left renal mass and a necrotic lesion limited to the spleen. Although not apparent on preoperative imaging, distal pancreatic mass was also discovered intraoperatively. Subsequently, left radical nephrectomy, splenectomy, and distal pancreatectomy were performed, and the synchronous primaries and splenic metastasis were confirmed histopathologically. This case is unique in that it demonstrates multiple extremely rare events occurring simultaneously, namely pancreatic and kidney primaries, as well as solitary splenic metastasis.
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Affiliation(s)
| | - Yacob Sheiferawe Seman
- Addis Ababa University, College of Health Sciences, Department of Urology, Addis Ababa, Ethiopia
| | - Hidaya Yahya Mohammed
- Addis Ababa University, College of Health Sciences, Department of Pathology, Addis Ababa, Ethiopia
| | - Fadil Nuredin Abrar
- Addis Ababa University, College of Health Sciences, Department of Pathology, Addis Ababa, Ethiopia
| | - Admassu Melaku Mikru
- Addis Ababa University, College of Health Sciences, Department of Urology, Addis Ababa, Ethiopia
| | - Mahlet Kifle Mersha
- Addis Ababa University, College of Health Sciences, Department of Radiology, Addis Ababa, Ethiopia
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Todorovic Đ, Stojanovic B, Filip M, Đorđevic Đ, Stankovic M, Jovanovic I, Spasic M, Milosevic B, Cvetkovic A, Radovanovic D, Jovanovic M, Stojanovic BS, Pantic D, Cvetkovic D, Jovanovic D, Markovic V, Stojanovic MD. Small Bowel Perforation Due to Renal Carcinoma Metastasis: A Comprehensive Case Study and Literature Review. Diagnostics (Basel) 2024; 14:761. [PMID: 38611674 PMCID: PMC11011689 DOI: 10.3390/diagnostics14070761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/28/2024] [Accepted: 04/01/2024] [Indexed: 04/14/2024] Open
Abstract
This case report presents a unique instance of small bowel perforation caused by solitary metastasis from renal cell carcinoma (RCC), a rare and complex clinical scenario. The patient, a 59-year-old male with a history of RCC treated with nephrectomy four years prior, presented with acute abdomen symptoms. Emergency diagnostic procedures identified a significant lesion in the small intestine. Surgical intervention revealed a perforated jejunal segment due to metastatic RCC. Postoperatively, the patient developed complications, including pneumonia and multi-organ failure, leading to death 10 days after surgery. Histopathological analysis confirmed the metastatic nature of the lesion. This case underscores the unpredictable nature of RCC metastasis and highlights the need for vigilance in post-nephrectomy patients. The rarity of small bowel involvement by RCC metastasis, particularly presenting as perforation, makes this case a significant contribution to medical literature, emphasizing the challenges in the diagnosis and management of such atypical presentations.
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Affiliation(s)
- Đorđe Todorovic
- Department of Urology, University Clinical Center Kragujevac, 34000 Kragujevac, Serbia; (Đ.T.); (M.F.); (Đ.Đ.); (D.P.)
| | - Bojan Stojanovic
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (M.S.); (B.M.); (A.C.); (D.R.)
| | - Milutinovic Filip
- Department of Urology, University Clinical Center Kragujevac, 34000 Kragujevac, Serbia; (Đ.T.); (M.F.); (Đ.Đ.); (D.P.)
| | - Đorđe Đorđevic
- Department of Urology, University Clinical Center Kragujevac, 34000 Kragujevac, Serbia; (Đ.T.); (M.F.); (Đ.Đ.); (D.P.)
| | - Milos Stankovic
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (M.S.); (B.M.); (A.C.); (D.R.)
| | - Ivan Jovanovic
- Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Marko Spasic
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (M.S.); (B.M.); (A.C.); (D.R.)
| | - Bojan Milosevic
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (M.S.); (B.M.); (A.C.); (D.R.)
| | - Aleksandar Cvetkovic
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (M.S.); (B.M.); (A.C.); (D.R.)
| | - Dragce Radovanovic
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (M.S.); (B.M.); (A.C.); (D.R.)
| | - Marina Jovanovic
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Bojana S. Stojanovic
- Department of Pathophysiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Damnjan Pantic
- Department of Urology, University Clinical Center Kragujevac, 34000 Kragujevac, Serbia; (Đ.T.); (M.F.); (Đ.Đ.); (D.P.)
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (M.S.); (B.M.); (A.C.); (D.R.)
| | - Danijela Cvetkovic
- Department of Genetics, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Dalibor Jovanovic
- Department of Pathology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (D.J.); (M.D.S.)
| | - Vladan Markovic
- Department of Radiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Milica Dimitrijevic Stojanovic
- Department of Pathology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (D.J.); (M.D.S.)
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3
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Wu J, Yu C, Shivappa N, Hébert JR, Xu X. Dietary inflammatory index and renal cancer risk: a prospective study. Food Funct 2023; 14:9287-9294. [PMID: 37779467 DOI: 10.1039/d3fo02158k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Background: High dietary inflammatory index (DII®) scores, representing pro-inflammatory diets, have been associated with increased risks for numerous cancers. However, the evidence for renal cancer is limited. In the present study, we aimed to assess the association between DII and renal cancer risk in the Prostate, Lung, Colorectal, and Ovarian (PLCO) cohort. Methods: Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using a Cox proportional hazards model with adjustment for various potential confounders. Results: After a median 12.2 years of follow-up, this study recorded 443 renal cancer cases among 101 190 individuals. The DII score was positively associated with renal cancer risk in multivariable analyses. The HR in the highest DII tertile compared to the lowest tertile was 1.38 (95% CI 1.03-1.84). This was also true when DII was analyzed as a continuous variable. The HR of one-unit increment in DII for renal cancer risk was 1.07 (95% CI 1.01-1.12). Conclusion: In this large American cohort, pro-inflammatory diet, as estimated by higher DII scores, was significantly associated with a greater risk of renal cancer. Future large prospective studies are warranted to verify these preliminary findings.
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Affiliation(s)
- Jian Wu
- Department of Urology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Chenchen Yu
- Department of Urology, Zhejiang Medical&Health Group Hangzhou Hospital, Hangzhou 310022, China
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, 29201, USA
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC, 29201, USA
| | - Xin Xu
- Department of Urology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
- Department of Urology, First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou 310003, China.
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Tu Y, Yu P, Yu L, Ji H, Wan Y, Shi L, Chen A, Zhong F. A Rare Case of Metastatic Clear Cell Renal Cell Carcinoma to the Petroclival Region Presenting as Posterior Cranial Neuropathies. EAR, NOSE & THROAT JOURNAL 2023:1455613231182670. [PMID: 37568274 DOI: 10.1177/01455613231182670] [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: 08/13/2023] Open
Abstract
We present a case of metastatic renal cell carcinoma (RCC) to the petroclival region with clinical symptoms manifested as posterior cranial neuropathies. A 65-year-old male presented with headache symptom for over 1 year, during which time he was diagnosed with RCC and underwent right nephrectomy. However, the headache symptom and cranial neuropathies had been attributed to cranial neuritis all the time until the surgical removal of metastatic tumor in the petroclival region led to the diagnosis of metastatic RCC. RCC has a tendency for metastasis early. The incidence of spread of RCC to brain is a rarity in clinical practice. When a patient presents with cranial nerve neuropathies, the possibility of metastatic RCC should be sought. Brain metastases display nonspecific presentations, and it is useful to examine with magnetic resonance imaging and computed tomography scans radiologically.
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Affiliation(s)
- Yanyi Tu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Peng Yu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Liang Yu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Hongzhi Ji
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yuzhu Wan
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Li Shi
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Aiping Chen
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Feng Zhong
- Department of Nursing, Shandong Second Provincial General Hospital, Jinan, China
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Zeng Q, Luo S, Chen L, Chen L, Chen J. Bladder metastasis from type 2 papillary renal cell carcinoma: A case report. Oncol Lett 2023; 25:270. [PMID: 37216161 PMCID: PMC10193377 DOI: 10.3892/ol.2023.13856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 04/05/2023] [Indexed: 05/24/2023] Open
Abstract
Renal cell carcinoma (RCC) is a common urinary tumor that may be pathologically divided into different subtypes: clear cell RCC, papillary RCC (PRCC) and chromophobe RCC. The most common organs of RCC metastasis are the lung, liver and bones, while bladder metastasis is rare. The treatment for PRCC metastasis is also a problem due to limited clinical data. Therefore, every single case of PRCC metastasis may significantly contribute to establishing a standard treatment protocol. The present study reported on a patient who suffered from repetitive bladder PRCC metastasis with 1.5 years of follow-up. A 54-year-old male patient was diagnosed with left renal pelvic carcinoma in March 2020 and underwent a laparoscopic radical nephroureterectomy of the left kidney. The postoperative histological examination revealed that the tumor was consistent with a type 2 PRCC. Bladder metastasis was discovered three months after the surgery and transurethral resection of the bladder tumor (TURBT) was performed to eliminate the tumor in the bladder. Only three months after the initial TURBT, bladder metastasis was detected again, combined with lung metastasis. The patient refused to undergo radical cystectomy. Therefore, a second TURBT was arranged and targeted drugs were administered. However, both bladder and lung metastases were insensitive to the treatment strategy applied, although immunotherapy was subsequently added. The patient died in October 2021 due to respiratory failure and cachexia. The report aims to provide the whole treatment progress and lessons learned from this case, which is relatively rare.
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Affiliation(s)
- Qinsong Zeng
- Department of Urology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Shuhang Luo
- Department of Urology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Linze Chen
- Department of Urology, Da Lang Hospital of Dongguan, Dongguan, Guangdong 523777, P.R. China
| | - Lingwu Chen
- Department of Urology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Junxing Chen
- Department of Urology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510080, P.R. China
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Kinjo T, Izumi H, Kanaki T, Oshima J, Shiba M, Inoue H. [SMALL RENAL CELL CARCINOMA METASTASIS TO THE IPSILATERAL PERIRENAL FAT SYNCHRONOUSLY: A CASE REPORT]. Nihon Hinyokika Gakkai Zasshi 2023; 114:93-98. [PMID: 39034122 DOI: 10.5980/jpnjurol.114.93] [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: 07/23/2024]
Abstract
Small renal cell carcinoma with metastases is rare; thus, to the best of our knowledge, this is the first case of synchronous metastasis to the ipsilateral perirenal fat.A 70-year-old man visited our hospital because of early gastric carcinoma. Contrast-enhanced computed tomography revealed a right renal tumor and two small nodules in the ipsilateral perirenal fat. The renal tumor was 3 cm in diameter and consistent with clear cell renal cell carcinoma. The enhancement pattern of the nodules was similar to that of the renal tumor, we diagnosed cT1aN0M1. Transperitoneal laparoscopic radical nephrectomy of the right kidney was performed. Postoperative pathological analysis showed clear cell renal cell carcinoma of the right kidney, pT1a, G2>1, INFa, v0, ly0, and two nodules in ipsilateral perirenal fat had comparable pathological findings. At 11th month of postoperative follow-up, CT revealed multiple nodules in the left pleura. Pembrolizumab plus axitinib was administered every 3 weeks. Multiple pleural metastases disappeared 3 months after the therapy; however, grade 2 (CTCAE v5.0) diarrhea and hoarseness emerged. Owing to the persistence of symptoms despite axitinib cessation, pembrolizumab was also discontinued. After 2 months of withdrawal, the patient's symptoms resolved spontaneously. After consultation with the patient, he was followed up with no further treatment. He is alive with no evidence of recurrence 36 months after surgery.
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Affiliation(s)
| | - Haruka Izumi
- The Department of Urology, Ikeda Municipal Hospital
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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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8
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Smart A, Wynne M, Baraban E, Ged Y, Smith A. Metastasis to the Bladder: A Rare Site of Recurrence of Renal Cell Carcinoma. Case Rep Urol 2022; 2022:4339270. [PMID: 35754920 PMCID: PMC9232330 DOI: 10.1155/2022/4339270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 05/24/2022] [Indexed: 11/18/2022] Open
Abstract
Renal cell carcinoma (RCC) is considered to be the deadliest urologic cancer with high rates of metastasis and recurrence after nephrectomy. RCC can metastasize to nearly any organ but most commonly metastasizes to the liver, lung, brain, and bone. To date, there are only about 40 reported cases of RCC with solitary bladder metastasis. The following report contributes to this limited data set of patients with RCC who develop solitary metastasis to the bladder. A 69-year-old male presented with occasional gross hematuria and was found to have a left renal mass infiltrating the collecting system. Ureteroscopic biopsy revealed clear cell RCC, and the patient subsequently underwent radical left nephrectomy. Eight months after nephrectomy, the patient presented to the clinic with gross hematuria. In-office cystoscopy demonstrated a nodular lesion in the bladder arising from the left ureteral orifice. The patient underwent transurethral resection of the bladder mass and pathology demonstrated clear cell RCC. Subsequent imaging showed no evidence of metastatic disease. Five months after transurethral resection, the patient was found to have a left distal ureteral mass and underwent left ureterectomy with partial cystectomy. Pathology again demonstrated clear cell RCC. RCC with solitary metastasis to the bladder is rare, and there are no targeted guideline recommendations for management. Per standard of care, patients with painless hematuria and risk factors for malignancy should undergo cystoscopy. In patients with a history of RCC, metastasis to the bladder should be considered in the differential diagnosis. Patients with metastatic RCC to the bladder should undergo a thorough work-up for additional sites of metastasis. In patients with RCC who develop solitary bladder metastasis amenable to resection following nephrectomy, there is a lack of evidence to guide therapy and a multidisciplinary discussion is warranted. However, if the tumor is amenable to resection, metastasectomy is a reasonable therapeutic approach and offers the patient an improved quality of life and an opportunity for remission.
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Affiliation(s)
- Amanda Smart
- Department of Urology, George Washington University Hospital, Washington, DC, USA
| | - Michael Wynne
- Department of Urology, George Washington University Hospital, Washington, DC, USA
| | - Ezra Baraban
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yasser Ged
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Armine Smith
- The James Buchanan Brady Urologic Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Wallace J, Abelardo E, Ramachandran K, Prabhu V. Renal cell carcinoma uvula metastasis leading to airway compromise: an unusual site. BMJ Case Rep 2022; 15:e248098. [PMID: 35396238 PMCID: PMC8995948 DOI: 10.1136/bcr-2021-248098] [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] [Accepted: 03/21/2022] [Indexed: 11/03/2022] Open
Abstract
We present a case report of a gentleman presenting with a globular lesion arising from his uvula. Although elective admission was planned, he presented with airway compromise, and emergency excision was required. The patient had a background of metastatic clear cell renal carcinoma; histology confirmed the uvula lesion as a further secondary deposit. Renal cell carcinoma has a recognised metastatic propensity, but spread to the uvula is rare, with only two previously described cases in the literature. This case is notable for the unusual location of the metastasis, as well as the rapid progression of symptoms, which threatened the airway and necessitated urgent surgical intervention.
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Affiliation(s)
| | - Edgardo Abelardo
- Otolaryngology, Glangwili General Hospital, Carmarthen, UK
- Institute of Life Sciences, Swansea University Medical School, Swansea, UK
| | | | - Vinod Prabhu
- Otolaryngology, Glangwili General Hospital, Carmarthen, UK
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10
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Ali S, Qasim A, Salah R, Sarwar MR, Usman M, Shams S. Isolated late intradural cauda equina metastasis of renal cell carcinoma. Surg Neurol Int 2021; 12:481. [PMID: 34754531 PMCID: PMC8571253 DOI: 10.25259/sni_721_2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 08/31/2021] [Indexed: 12/02/2022] Open
Abstract
Background: The cauda equina (CE) is the most common site for intradural extramedullary metastasis from systemic malignancies such as lung, breast, and thyroid carcinomas. However, renal cell carcinomas (RCC), with their high metastatic potential, are rarely responsible for CE metastatic lesions. Here, we report an intradural cauda equina mass, as the first and only site of metastasis of a renal cell carcinoma. Case Description: A 55-year-old female had undergone a left nephrectomy for renal cell carcinoma 8 years ago. She now presented with a unifocal renal cell metastasis to the CE. As such metastases are rare, establishing the correct pathological diagnosis proved to be a challenge. Conclusion: The cauda equina was the first and only site of an 8-year-delayed metastasis attributed to a renal cell carcinoma.
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Affiliation(s)
- Sundus Ali
- Department of Neurosurgery, King Edward Medical University, Lahore, Mayo Hospital, Lahore, Punjab, Pakistan
| | - Adnan Qasim
- Department of Neurosurgery, King Edward Medical University, Lahore, Mayo Hospital, Lahore, Punjab, Pakistan
| | - Rahmatullah Salah
- Department of Neurosurgery, King Edward Medical University, Lahore, Mayo Hospital, Lahore, Punjab, Pakistan
| | - Muhammad Rizwan Sarwar
- Department of Neurosurgery, King Edward Medical University, Lahore, Mayo Hospital, Lahore, Punjab, Pakistan
| | - Muhammad Usman
- Department of Neurosurgery, King Edward Medical University, Lahore, Mayo Hospital, Lahore, Punjab, Pakistan
| | - Shahzad Shams
- Department of Neurosurgery, King Edward Medical University, Lahore, Mayo Hospital, Lahore, Punjab, Pakistan
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11
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Zhang Z, Liang C, Hou B, Zhou L. Population-based evaluation of the risk factors and prognosis among renal cell carcinoma patients with initially diagnosed lung metastases. Actas Urol Esp 2021; 45:498-506. [PMID: 34332926 DOI: 10.1016/j.acuroe.2021.06.004] [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: 03/26/2020] [Accepted: 06/07/2020] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To evaluate risk factors and prognosis of lung metastases in patients with renal cell carcinoma (RCC) based on the Surveillance, Epidemiology, and End Results (SEER) database. METHODS 56,617 patients with RCC were selected from the SEER database. Based on univariate and multivariate logistic regression, the risk factors for developing lung metastases were derived. 2906 patients were initially diagnosed with lung metastases, and then were used to research the prognostic factors. Multivariable Cox regression analyses were performed for the prediction of cancer-specific mortality. RESULTS In total, 2906 RCC patients were initially diagnosed with lung metastases. The prevalence of lung metastases in RCC was approximately 5% with poor survival. Aging, male, other race (American Indian/AK native, Asian Pacific islander) uninsured status, bilateral tumor, collecting duct, higher T stage, local lymph node metastases, higher tumor grade, and evidence of other distant metastases were significantly associated with developing lung metastases at diagnosis. Age >70 years-old, black, female, bilateral tumor, T4 stage, higher tumor grade, local lymph node metastases, collecting duct, and evidence of bone, liver, or brain metastases were related to higher risk of mortality. Blacks and female have lower odds of developing lung metastases at the time of diagnosis both in crude and adjusted logistic regression. Meanwhile, blacks and female showed higher risk of mortality compared with whites and male in Cox regression analyses. CONCLUSION Several factors related to the development and prognosis of lung metastases were revealed, especially black people and female gender have lower risk of developing lung metastatic RCC at initial diagnosis but have higher risk of mortality. These may provide preventive guidelines for the screening and treatment of lung metastases in patients with renal cell carcinoma.
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Affiliation(s)
- Z Zhang
- Department of Urology, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, China.
| | - C Liang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - B Hou
- Department of Urology, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, China
| | - L Zhou
- Department of Urology, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, China
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12
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Dergel M, Balik M, Pacovsky J, Vobornik M, Mandak J, Laco J. Solitary metastasis of clear cell renal cell carcinoma in sternum diagnosed unexpectedly during cardiac surgery - A rare but potentially fatal trap. Urol Case Rep 2021; 38:101730. [PMID: 34136359 PMCID: PMC8181793 DOI: 10.1016/j.eucr.2021.101730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 05/22/2021] [Accepted: 05/25/2021] [Indexed: 12/24/2022] Open
Abstract
We present a very rare case of fatal complication during the cardiac surgery caused by unrecognized solitary metastasis of clear cell renal cell carcinoma in the sternum.
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Affiliation(s)
- Martin Dergel
- Department of Cardiac Surgery, Charles University Faculty of Medicine in Hradec Kralove and University Hospital Hradec Kralove, Czech Republic
| | - Michal Balik
- Department of Urology, Charles University Faculty of Medicine in Hradec Kralove and University Hospital Hradec Kralove, Czech Republic
| | - Jaroslav Pacovsky
- Department of Urology, Charles University Faculty of Medicine in Hradec Kralove and University Hospital Hradec Kralove, Czech Republic
| | - Martin Vobornik
- Department of Cardiac Surgery, Charles University Faculty of Medicine in Hradec Kralove and University Hospital Hradec Kralove, Czech Republic
| | - Jiri Mandak
- Department of Cardiac Surgery, Charles University Faculty of Medicine in Hradec Kralove and University Hospital Hradec Kralove, Czech Republic
| | - Jan Laco
- The Fingerland Department of Pathology, Charles University Faculty of Medicine in Hradec Kralove and University Hospital Hradec Kralove, Czech Republic
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13
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Zhang Z, Liang C, Hou B, Zhou L. Population-based evaluation of the risk factors and prognosis among renal cell carcinoma patients with initially diagnosed lung metastases. Actas Urol Esp 2021. [PMID: 33958221 DOI: 10.1016/j.acuro.2020.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To evaluate risk factors and prognosis of lung metastases in patients with renal cell carcinoma (RCC) based on the Surveillance, Epidemiology, and End Results (SEER) database. METHODS 56, 617 patients with RCC were selected from the SEER database. Based on univariate and multivariate logistic regression, the risk factors for developing lung metastases were derived. 2, 906 patients were initially diagnosed with lung metastases, and then were used to research the prognostic factors. Multivariable Cox regression analyses were performed for the prediction of cancer-specific mortality. RESULTS In total, 2,906 RCC patients were initially diagnosed with lung metastases. The prevalence of lung metastases in RCC was approximately 5% with poor survival. Aging, male, other race (American Indian /AK native, Asian Pacific islander) uninsured status, bilateral tumor, collecting duct, higher T stage, local lymph node metastases, higher tumor grade, and evidence of other distant metastases were significantly associated with developing lung metastases at diagnosis. Age > 70 years-old, black, female, bilateral tumor, T4 stage, higher tumor grade, local lymph node metastases, collecting duct, and evidence of bone, liver, or brain metastases were related to higher risk of mortality. Blacks and female have lower odds of developing lung metastases at the time of diagnosis both in crude and adjusted logistic regression. Meanwhile, blacks and female showed higher risk of mortality compared with whites and male in Cox regression analyses. CONCLUSION Several factors related to the development and prognosis of lung metastases were revealed, especially black people and female gender have lower risk of developing lung metastatic RCC at initial diagnosis but have higher risk of mortality. These may provide preventive guidelines for the screening and treatment of lung metastases in patients with renal cell carcinoma.
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Verma V, Israrahmed A, Rao RN. Metastatic clear cell renal cell carcinoma presenting as breast lump: A rare case report. Diagn Cytopathol 2021; 49:E281-E285. [PMID: 33609330 DOI: 10.1002/dc.24710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/13/2021] [Accepted: 01/26/2021] [Indexed: 11/11/2022]
Abstract
Renal cell carcinoma is as an aggressive tumor associated with metastasis in about one-third of the cases, but it rarely metastasizes to breast, which further is a rare site of metastasis from extramammary solid tumors. Here, we report the case of a 60-year-old female who presented with breast metastasis from renal cell carcinoma. The mammogram showed a well-defined hyperdense mass of 2.5 × 2.7 cm with microlobulated margins. The mass was hypervascular on ultrasound. Further, contrast enhanced computed tomography (CECT) abdomen revealed a 6.3 × 6.0 × 6.2 cm mass arising from the middle and the lower pole of right kidney. Fine-needle aspiration cytology (FNAC) of the right breast lump, along with cellblock preparation from the aspirated material and immunohistochemistry (IHC) on the cellblock was performed. The tumor was positive for pan-cytokeratin, vimentin, and CD10, while the markers for primary breast carcinoma were negative. On the basis of morphology and IHC, the final diagnosis of the breast mass was metastatic clear cell renal cell carcinoma. This case highlights the importance of ruling out possibility of metastasis in cases of breast mass. The correct diagnosis of these cases is crucial since the mastectomy is not required. Here, we discuss the radiological and morphological features on cytology and cellblock of this rare case of breast metastasis from renal cell carcinoma.
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Affiliation(s)
- Vikrant Verma
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India
| | - Amrin Israrahmed
- Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India
| | - Ram N Rao
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India
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15
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Patil PG, Reddy P, Rawat S, Ananthasivan R, Sinha R. Multimodality Approach in Detection and Characterization of Hepatic Metastases. JOURNAL OF GASTROINTESTINAL AND ABDOMINAL RADIOLOGY 2020. [DOI: 10.1055/s-0039-3402100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
AbstractEarly detection of liver metastases is important in patients with known primary malignancies. This plays an important role in treatment planning and impacts on further management of certain primary malignancies.Magnetic resonance imaging (MRI), computed tomography (CT), and positron emission tomography-computed tomography scans are reported to have high accuracy in the diagnosis of intrahepatic lesions. MRI in particular has the advantages of its high tissue sensitivity and its multiparametric approach.Hepatic metastatic lesions have considerable overlap in their radiological appearance, and in this article the imaging appearance of various hepatic metastasis and approach is described.
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Affiliation(s)
- Pooja G. Patil
- Department of Radiology, Manipal Hospital, Bangalore, Karnataka, India
| | - Pramesh Reddy
- Department of Radiology, Manipal Hospital, Bangalore, Karnataka, India
| | - Sudarshan Rawat
- Department of Radiology, Manipal Hospital, Bangalore, Karnataka, India
| | - Rupa Ananthasivan
- Department of Radiology, Manipal Hospital, Bangalore, Karnataka, India
| | - Rakesh Sinha
- Department of Radiology, South Warwickshire NHS Foundation Trust, Warwick, United Kingdom
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16
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Munir A, Khan AM, McCarthy L, Mehdi S. An Unusual Case of Renal Cell Carcinoma Metastasis to Duodenum Presenting as Gastrointestinal Bleeding. JCO Oncol Pract 2019; 16:49-50. [PMID: 31721625 DOI: 10.1200/jop.19.00268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
| | | | | | - Syed Mehdi
- Stratton Veterans Affairs Medical Center, Albany, NY
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17
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Pozzessere C, Bassanelli M, Ceribelli A, Rasul S, Li S, Prior JO, Cicone F. Renal Cell Carcinoma: the Oncologist Asks, Can PSMA PET/CT Answer? Curr Urol Rep 2019; 20:68. [PMID: 31605269 DOI: 10.1007/s11934-019-0938-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW To critically review the potential clinical applications of prostate-specific membrane antigen (PSMA) radioactive ligands in renal cell carcinoma (RCC). RECENT FINDINGS Radioactive probes targeting PSMA hold promise in several malignancies in addition to prostate cancer, owing to the expression of PSMA by tumor neovasculature. The majority of clear cell RCCs (ccRCC), the most malignant RCC subtype, express PSMA on tumor-associated neovasculature. The endothelium of less aggressive RCC subtypes is PSMA positive in a lower, but still significant percentage of cases. PSMA might therefore represent an interesting theragnostic target in RCC. The preliminary data available suggest a potential role for PSMA-targeting radiopharmaceuticals in complementing conventional imaging for staging ccRCC patients at risk of nodal involvement and oligometastatic disease. Additional applications of PSMA imaging may be the selection and the response assessment of patients receiving anti-angiogenic treatments. The effectiveness of PSMA-targeting radionuclide therapy should also be investigated.
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Affiliation(s)
- Chiara Pozzessere
- Department of Radiology, AUSL Toscana Centro San Giuseppe Hospital, Viale Boccaccio 20, 50053, Empoli, Italy.
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
| | - Maria Bassanelli
- Division of Medical Oncology, San Camillo De Lellis Hospital, Rieti, Italy
| | - Anna Ceribelli
- Division of Medical Oncology, San Camillo De Lellis Hospital, Rieti, Italy
| | - Sazan Rasul
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Shuren Li
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - John O Prior
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Francesco Cicone
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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18
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Farrokh D, Rad MP, Mortazavi R, Akhavan R, Abbasi B. Local recurrence of renal cell carcinoma presented with massive gastrointestinal bleeding: management with renal artery embolization. CVIR Endovasc 2019; 2:10. [PMID: 32026999 PMCID: PMC6966418 DOI: 10.1186/s42155-019-0054-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 02/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gastrointestinal bleeding from renal cell carcinoma metastasis is an uncommon manifestation of tumor recurrence and is usually difficult to control. Palliative trans-catheter embolization to control the bleeding has been used and described in the literature. CASE PRESENTATION The present report describes a 62- years-old male with local recurrence of RCC who presented with upper GI bleeding as the primary manifestation 10 years after right-sided partial nephrectomy. A pseudoaneurysm of renal artery with erosion into the duodenal lumen was responsible for the massive bleeding and was controlled with coil embolization. CONCLUSION This case report highlights the importance of high index suspicion in post-nephrectomy patients for RCC, presenting with new symptoms. Aggressive gastrointestinal workup and adequate awareness of available minimally-invasive endovascular options for controlling GIB in these patients, are of paramount importance.
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Affiliation(s)
- Donya Farrokh
- Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Imam Reza hops, Razi Sq, Mashhad, Iran
| | - Masoud Pezeshki Rad
- Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Imam Reza hops, Razi Sq, Mashhad, Iran
| | - Reihaneh Mortazavi
- Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Imam Reza hops, Razi Sq, Mashhad, Iran
| | - Reza Akhavan
- Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Bita Abbasi
- Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Imam Reza hops, Razi Sq, Mashhad, Iran.
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19
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Ramez AM, Hamed M, Saad EA. Metastatic renal cell carcinoma to the eyelid: an unusual presentation. JOURNAL OF CLINICAL UROLOGY 2019. [DOI: 10.1177/2051415819827687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Ahmed M Ramez
- Medical Oncology Department, Mansoura University, Egypt
| | - Manar Hamed
- Medical Oncology Department, Mansoura University, Egypt
| | - Eman A Saad
- Pathology Department, Mansoura University, Egypt
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20
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Wang W, Li H, Li Y, Gao Z, Feng F, Lin C. Metachronous metastasis to contralateral retroperitoneal adipose tissue after radical nephrectomy: a case report and review of the literature. J Int Med Res 2018; 47:1035-1042. [PMID: 30556455 PMCID: PMC6381487 DOI: 10.1177/0300060518816174] [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] [Indexed: 12/27/2022] Open
Abstract
Renal cell carcinoma (RCC) metastasis to the adrenal gland, perirenal adipose tissue, and ureter on the contralateral side is rare. We report a case of solitary metachronous clear cell renal cell carcinoma (ccRCC) metastasis to the contralateral retroperitoneal adipose tissue, which was identified after radical nephrectomy. A patient had undergone retroperitoneal laparoscopic radical nephrectomy for RCC in the right kidney in December 2012. Postoperative pathological analysis showed Fuhrman grade I ccRCC, T1bN0M0. Three years after surgery, a solitary tumor of 1.0 × 1.0 cm was identified by an abdominal computed tomographic scan inside the retroperitoneal fat pad in front of the left posterior abdominal wall, without adhesion to the abdominal wall. The tumor was then completely resected by retroperitoneal laparoscopic resection. Pathological analysis showed that it was a metastasized lesion from a previous tumor. Nine months after surgery, there was no sign of recurrence confirmed by radiographic follow-up. Findings from this case indicate the unpredictability of dissemination of RCC. Our findings support a follow-up regimen that includes regular postoperative computed tomographic scans to identify early metastasis. To the best of our knowledge, this is the first reported case of contralateral retroperitoneal adipose metastasis after laparoscopic tumorectomy.
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Affiliation(s)
- Wenting Wang
- 1 The Central Laboratory Department, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Hui Li
- 2 Department of Pediatrics, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Yongwei Li
- 3 Department of Urological Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Zhenli Gao
- 3 Department of Urological Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Fan Feng
- 3 Department of Urological Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
| | - Chunhua Lin
- 3 Department of Urological Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China
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Porfyris O, Alexandrou P, Masaoutis C, Nikolakakos F. Ovarian metastasis of renal cell carcinoma: Clinical and pathological presentation of a case. Turk J Urol 2018; 45:150-153. [PMID: 30875293 DOI: 10.5152/tud.2018.96237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 10/09/2017] [Indexed: 11/22/2022]
Abstract
A 82-year-old woman was referred to our hospital with complaints of weight loss, loss of appetite, abdominal pain and a palpable pelvic mass. Abdominal imaging revealed a tumour at the upper pole of the right kidney with a maximum diameter of 8 cm and a second tumour in the pelvis, mostly solid, with a maximum diameter of 16 cm, that seemed to originate from the left ovary. As she was initially considered to have two distinct tumours, through a single transabdominal incision, she simultaneously underwent right radical nephrectomy and also bilateral salpingo-oophorectomy for the tumour that originated from the left ovary. Histopathological examination showed that the tumour in the right kidney was a clear-cell renal cell carcinoma (RCC) (stage pT3a, Fuhrman grade 2). The ovarian tumour proved to be an ovarian fibroma that included a circumscribed focus with a diameter of 0.7 cm which was a metastasis from the kidney tumour. Immunohistochemistry contributed significantly to the diagnosis, as the focus showed strong and diffuse expression of CD10 and RCC antigen, which are reliable markers of RCC. With less than 30 reported cases in the literature, it is very important to differentiate ovarian metastasis of RCC from primary ovarian tumour due to different treatment alternatives and prognosis.
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Affiliation(s)
- Orestis Porfyris
- Department of Urology, General Hospital of Laconia, Sparta, Greece
| | | | - Christos Masaoutis
- Department of Pathology, National and Kapodistrian University, Athens, Greece
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22
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Bibi M, Sellami A, Ouanes Y, Kassar AZ, Jallouli W, Zairi S, Souid A, Ben Chehida MA, Ben Rhouma S, Marghli A, Nouira Y. An unusual case of solitary sternal metastasis of renal cell carcinoma. Urol Case Rep 2018; 21:29-31. [PMID: 30175047 PMCID: PMC6116421 DOI: 10.1016/j.eucr.2018.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 08/15/2018] [Indexed: 11/08/2022] Open
Affiliation(s)
- Mokhtar Bibi
- Department of Urology La Rabta Hospital, Tunis, Tunisia
| | - Ahmed Sellami
- Department of Urology La Rabta Hospital, Tunis, Tunisia
| | | | | | | | - Sarra Zairi
- Department of Thoracic and Cardiovascular Surgery Abderrahmen Mami Hospital, Ariana, Tunisia
| | - Asma Souid
- Department of Radiology La Rabta Hospital, Tunis, Tunisia
| | | | | | - Adel Marghli
- Department of Thoracic and Cardiovascular Surgery Abderrahmen Mami Hospital, Ariana, Tunisia
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Bhattacharya R, Panda CK, Nandi S, Mukhopadhyay A. An insight into metastasis: Random or evolving paradigms? Pathol Res Pract 2018; 214:1064-1073. [PMID: 30078401 DOI: 10.1016/j.prp.2018.06.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/05/2018] [Accepted: 06/25/2018] [Indexed: 12/20/2022]
Abstract
Mechanical or fostered molecular events define metastatic cascade. Three distinct sets of molecular events characterize metastasis, viz invasion of extracellular matrix; angiogenesis, vascular dissemination and anoikis resistance; tumor homing and relocation of tumor cells to selective organ. Invasion of extracellular matrix requires epithelial to mesenchymal transition through disrupted lamellopodia formation and contraction of actin cytoskeleton; aberration of Focal adhesion complex formation involving integrins and the extracellular matrix; degradation of extracellular matrix by matrix metalloproteases; faulty immune surveillance in tumor microenvironment and an upregulated proton efflux pump NHE1 in tumors. Vascular dissemination and anoikis resistance depend upon upregulation of integrins, phosphorylation of CDCP1, attenuated apoptotic pathways and upregulation of angiogenesis. Tumor homing depends on recruitment of mesenchymal stem cells, expression on chemokines and growth factors, upregulated stem cell renewal pathways. Despite of many potential challenges in curbing metastasis, future targeted therapies involving immunotherapy, stem cell engineered and oncolytic virus based therapy, pharmacological activation of circadian clock are held promising. To sum up, metastasis is a complex cascade of events and warrants detailed molecular understanding for development of therapeutic strategies.
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Affiliation(s)
- Rittwika Bhattacharya
- Department of Molecular Biology, Netaji Subhas Chandra Bose Cancer Research Institute, 16A Park Lane, Kolkata, 700016, India.
| | - Chinmay Kumar Panda
- Department of Oncogene Regulation, Chittaranjan National Cancer Institute, 37 S.P Mukherjee Road, Kolkata, 700026, India.
| | - Sourav Nandi
- Department of Molecular Biology, Netaji Subhas Chandra Bose Cancer Research Institute, 16A Park Lane, Kolkata, 700016, India.
| | - Ashis Mukhopadhyay
- Department of Haemato-Oncology, Netaji Subhas Chandra Bose Cancer Research Institute, 16A Park Lane, Kolkata, 700016, India.
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24
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Kuklik E, Światłowski Ł, Sojka M, Szczerbo-Trojanowska M. Endovascular Embolization of Renal Cell Carcinoma in a Patient with Solitary Kidney. Pol J Radiol 2018; 82:494-497. [PMID: 29662578 PMCID: PMC5894043 DOI: 10.12659/pjr.901219] [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: 08/24/2016] [Accepted: 11/02/2016] [Indexed: 12/31/2022] Open
Abstract
Background Kidney tumors account for about 3% of tumors in adults. The primary therapy of renal cancer is the surgical removal. Traditionally, and also modern procedures are performed to remove the kidneys, especially when the tumor involves the entire kidney. In the cases of unresectable tumors embolization is used as a palliative procedure. Case Report The aim of this study is to present the case of endovascular treatment of renal cell carcinoma in patient with solitary kidney. 77-years old patient had an ultrasound examination because of the pain in left lumbar region. MRI confirmed the presence of tumor size 29×45 mm in the left kidney. The right kidney had been removed eight years earlier because of clear cell carcinoma. Histopathological diagnosis was renal clear cell carinoma. The patient did not consent to surgical treatment. Tumor embolization was proceeded as a minimally invasive procedure. Pathological tumor vessels were closed using particles filling the entire vascular tumor. Next, the blood vessels supplying the tumor were closed using a mixture of lipiodolu and glubranu. Control angiographiy of the left renal artery confirmed the effective closure of all vascular pathology. In a recent ultrasound examination which was done 15 months after surgery no evidence of vascular pathology was found. Conclusions Embolization of kidney cancer in particular cases may be an alternative way of treatment and give a good result in the form of stopping the growth of the tumor with simultaneous retaining the remaining parenchyma and renal function.
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Affiliation(s)
- Ewa Kuklik
- Department of Radiology and Interventional Neuroradiology, Independent Public Hospital No. 4 (SPSK 4), Lublin, Poland
| | - Łukasz Światłowski
- Department of Radiology and Interventional Neuroradiology, Independent Public Hospital No. 4 (SPSK 4), Lublin, Poland
| | - Michał Sojka
- Department of Radiology and Interventional Neuroradiology, Independent Public Hospital No. 4 (SPSK 4), Lublin, Poland
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25
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Cheong D, Rho SY, Kim JH, Kang CM, Lee WJ. Laparoscopic pancreaticoduodenectomy for renal cell carcinoma metastasized to ampulla of Vater: A case report and literature review. Ann Hepatobiliary Pancreat Surg 2018. [PMID: 29536061 PMCID: PMC5845616 DOI: 10.14701/ahbps.2018.22.1.83] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Renal cell carcinoma is the most common primary renal neoplasm in adults. Although renal cell carcinoma is known to spread to unusual sites, the ampulla of Vater is considered a rare site for metastasis. Here we present a case of renal cell carcinoma metastasized to the ampulla of Vater along with literature review. A 62-year-old Korean male had a history of hypertension and right-sided renal cell carcinoma diagnosed in September 2004, for which he underwent right radical nephrectomy in October 2004. The patient eventually underwent laparoscopic pylorus-preserving total pancreaticoduodenectomy in January 2017. The surgery was successful without postoperative complications. Previous studies have shown that surgical resection for solitary metastases of renal cell carcinoma can provide favorable survival rates. Our case report provides evidence that pancreaticoduodenectomy may be a treatment of choice for suitable patients with solitary renal cell carcinoma ampullary metastasis. A minimally invasive approach may result in early recovery of patient to be suitable for subsequent chemotherapy. Further evidence is needed to address the exact role of minimally invasive pancreaticoduodenectomy in renal cell carcinoma metastasized to the ampulla of Vater.
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Affiliation(s)
- Dominic Cheong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Seoung Yoon Rho
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.,Pancreatobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, Korea
| | - Ji Hong Kim
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.,Pancreatobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, Korea
| | - Chang Moo Kang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.,Pancreatobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, Korea
| | - Woo Jung Lee
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.,Pancreatobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul, Korea
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26
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Komanski CB, Rubino SM, Meyer JC, Greven CM. Choroidal Melanoma Mimicker: A Case of Metastatic Clear-Cell Renal Cell Carcinoma. Ocul Oncol Pathol 2018; 3:279-282. [PMID: 29344481 DOI: 10.1159/000462975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 02/03/2017] [Indexed: 11/19/2022] Open
Abstract
Choroidal melanoma is the most common primary intraocular malignancy, yet metastatic disease remains the most common malignancy of the eye. Differentiating these entities is essential as treatment, systemic associations, and prognosis vary dramatically between the two. Established diagnostic criteria are accurate for the diagnosis of uveal melanoma. Yet, metastatic disease may be misdiagnosed as a uveal melanoma in rare cases. We report a case of metastatic clear-cell renal cell carcinoma masquerading as uveal melanoma. A 73-year-old Caucasian man with a history of renal cell carcinoma presented with a 15 × 12 × 7 mm homogenous, pigmented, and acoustically hollow mass without hemorrhage or exudation. The patient was initially treated with plaque radiotherapy with good tumor regression. However, the patient developed pain and vision loss due to total exudative retinal detachment. Subsequent enucleation allowed histopathologic confirmation of clear-cell renal cell carcinoma. Nine years following enucleation, the patient remains in complete remission without evidence of other systemic metastases. Renal cell carcinoma should be considered when evaluating patients with probable uveal melanoma. Delayed-onset ocular metastasis from renal cell carcinoma exhibits an atypical clinical course with the possibility of durable remission following enucleation.
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Affiliation(s)
- Chris B Komanski
- Department of Ophthalmology, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA
| | - Shaina M Rubino
- Department of Ophthalmology, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA
| | - Jacob C Meyer
- Department of Ophthalmology, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA
| | - Craig M Greven
- Department of Ophthalmology, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA
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27
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Čerškutė M, Kinčius M, Januškevičius T, Cicėnas S, Ulys A. Sternal resection of a solitary renal cell carcinoma metastasis: a case report and a literature review. Acta Med Litu 2018; 25:226-233. [PMID: 31308828 PMCID: PMC6591693 DOI: 10.6001/actamedica.v25i4.3933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 02/19/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Renal cell carcinoma (RCC) may be metastatic, although solitary sternal metastasis of RCC is a rare medical condition. Here we report an unusual case of a 63-year-old male with a solitary sternal metastasis as an initial presentation of clear-cell renal cell carcinoma. MATERIALS AND METHODS A 63-year-old male presented with a small sternal mass. Chest computer tomography (CT) and a biopsy from the sternal tumour were performed. Histopathological examination revealed the diagnosis of renal clear cell carcinoma metastasis to the sternal bone. On the basis of a subsequently performed abdominal CT the patient was confirmed with a suspicion of a left renal lower pole tumour. Treatment with sunitinib was initiated. Due to the limited response and a growing sternal mass, the patient was admitted to the National Cancer Institute after two cycles of sunitinib therapy. Open left partial nephrectomy was performed followed by the resection of the sternal metastasis two months later. The chest wall was reconstructed with polypropylene mesh combined with transversal rectus abdominis musculocutaneous flap. RESULTS The postoperative course after the partial nephrectomy was uneventful. The postoperative course of metastasectomy complicated with the right pneumothorax which was successfully treated by insertion of a chest tube. Bleeding from the upper digestive tract also occurred on the seventh postoperative day but was successfully controlled by haemostasis with three 20 ml endoscopic injections of 1:10,000 solution of epinephrine. The patient had been followed up after the surgery for 30 months with biannual chest and abdominal CT scans that showed neither local nor distant recurrence of the disease. CONCLUSIONS Radical surgical treatment of a solitary renal clear cell carcinoma metastasis may offer the best cancer-specific outcomes and improve the quality of life in some patients.
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Affiliation(s)
| | - Marius Kinčius
- Department of Onco-urology, National Cancer Institute, Vilnius, Lithuania
| | | | - Saulius Cicėnas
- Department of Thoracic Surgery and Oncology, National Cancer Institute, Vilnius, Lithuania
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Albertas Ulys
- Department of Onco-urology, National Cancer Institute, Vilnius, Lithuania
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Kaminska K, Czarnecka AM, Khan MI, Fendler W, Klemba A, Krasowski P, Bartnik E, Szczylik C. Effects of cell-cell crosstalk on gene expression patterns in a cell model of renal cell carcinoma lung metastasis. Int J Oncol 2017; 52:768-786. [PMID: 29286165 PMCID: PMC5807041 DOI: 10.3892/ijo.2017.4234] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Accepted: 12/04/2017] [Indexed: 01/28/2023] Open
Abstract
The median survival rate of patients with metastatic renal carcinoma is approximately 10 to 12 months, with up to 50% of patients developing metastases in the lung parenchyma. The molecular basis for metastatic development remains unclear. In the present study, we used renal cell carcinoma (RCC) cells and bronchial epithelial cells, representing metastasis target organ cells, conditioned medium and co-culture models to identify specific gene expression changes responsible for cancer cell viability in a metastatic microenvironment. RCC cell proliferation and migration increased when the culture was supplemented with conditioned medium from lung fibroblasts or pleural epithelial cells. Healthy epithelial cells were, in turn, also stimulated with conditioned medium from RCC cell lines. The mitogen-activated protein kinase (MAPK), interleukin (IL)-6, and phosphatidylinositol 4,5-bisphosphate (PIP2) signaling pathways were identified as deregulated upon cell‑cell interaction. Thus, cell-cell communication may contribute to the development of the metastatic niche. The identified deregulated signaling pathways may be considered as potential therapeutic targets in metastatic renal carcinoma.
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Affiliation(s)
- Katarzyna Kaminska
- Department of Oncology, Military Institute of Medicine, 04‑141 Warsaw, Poland
| | - Anna M Czarnecka
- Department of Oncology, Military Institute of Medicine, 04‑141 Warsaw, Poland
| | - Mohammed Imran Khan
- Department of Oncology, Military Institute of Medicine, 04‑141 Warsaw, Poland
| | - Wojciech Fendler
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, 92‑215 Lodz, Poland
| | - Aleksandra Klemba
- Department of Oncology, Military Institute of Medicine, 04‑141 Warsaw, Poland
| | - Pawel Krasowski
- Department of Oncology, Military Institute of Medicine, 04‑141 Warsaw, Poland
| | - Ewa Bartnik
- Institute of Genetics and Biotechnology, Faculty of Biology, University of Warsaw, 02‑106 Warsaw, Poland
| | - Cezary Szczylik
- Department of Oncology, Military Institute of Medicine, 04‑141 Warsaw, Poland
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29
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Liu Y, Fu QZ, Pu L, Song LL, Wang YY, Liu J, Wang ZL, Wang ZM. Effect of RNA interference of the expression of HMGA2 on the proliferation and invasion ability of ACHN renal cell carcinoma cells. Mol Med Rep 2017; 16:5107-5112. [PMID: 28849119 PMCID: PMC5647043 DOI: 10.3892/mmr.2017.7258] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 04/04/2017] [Indexed: 11/06/2022] Open
Abstract
This aim of the present study was to observe the effect of high mobility group AT-hook 2 (HMGA2) on the proliferation and invasion ability of ACHN renal cell carcinoma (RCC) cells. Human ACHN cells, an RCC cell line, and HKC normal human renal tubular epithelial cells were cultured. HMGA2 small interfering (si)RNA, Mock-siRNA and their negative control group were designed and synthesized. Subsequently, the ACHN cells were transiently transfected using RNA interference technology. Finally, the mRNA and protein expression levels of HMGA2 were detected using reverse transcription-polymerase chain reaction and western blot analyses. The proliferation ability of the ACHN cells was determined using MTT, and ACHN cell invasion ability was detected using the Transwell method. The results showed that the mRNA and protein expression levels of HMGA2 in the ACHN cells were considerably higher, compared with those in the HKC cells (P<0.01). The RCC cells, in which the expression of HMGA2 was specifically silenced, was successfully constructed. The proliferation rate of cells in the HMGA2-siRNA group was significantly lower, compared with that of cells in the Mock-siRNA group and control group at 24, 48, 72 and 96 h post-transfection (P<0.05). The invasion ability of cells in the HMGA2-siRNA group was significantly lower, compared with that of cells in the Mock-siRNA group and control group (P<0.05) 48 h following transfection. Therefore, the HMGA2 gene may function as an oncogene in the occurrence and development of RCC, and provide specific targets for the targeted therapy of RCC. Further detailed investigations of the HMGA2 gene are important for future gene therapy of RCC.
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Affiliation(s)
- Ying Liu
- Xi'an Jiaotong University Health Science Center, Xi'an, Shanxi 710049, P.R. China
| | - Qi-Zhong Fu
- Department of Urological Surgery, The Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning 116001, P.R. China
| | - Lin Pu
- Department of Urological Surgery, The Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning 116001, P.R. China
| | - Ling-Ling Song
- Department of Urological Surgery, The Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning 116001, P.R. China
| | - Yi-Yun Wang
- Department of Urological Surgery, The Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning 116001, P.R. China
| | - Jing Liu
- Department of Urological Surgery, The Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning 116001, P.R. China
| | - Zhen-Long Wang
- Department of Urological Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi 710004, P.R. China
| | - Zi-Ming Wang
- Department of Urological Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shanxi 710004, P.R. China
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30
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Dhannoon SM, Alsaad AA, Asmar AR, Shahin FH. Renal cell carcinoma with isolated breast metastasis. BMJ Case Rep 2017; 2017:bcr-2016-219124. [PMID: 28619739 DOI: 10.1136/bcr-2016-219124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Renal cell carcinoma (RCC) is a highly prevalent disease worldwide with many cases being metastasised to various organs during the time of initial presentation. Metastatic RCC to the breast is a rare entity and can mimic primary breast carcinoma. In this article, we present a 63-year-old Caucasian woman presented with a breast mass that was detected by screening mammography and found to have a biopsy proven grade-II clear RCC in the breast tissue. Despite the high incidence and prevalence of primary breast cancer, metastasis from extramammary should be suspected in patients with a prior history of other cancers. In this brief literature review, we also highlight the survival benefit from surgery and close follow-up in selected group of patients with metastatic, metachronous and solitary RCC.
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Affiliation(s)
- Sarah M Dhannoon
- Department of Internal Medicine, University of Central Florida, Orlando, Florida, USA
| | - Ali A Alsaad
- Department of Internal Medicine, Mayo Clinic Florida, Jacksonville, Florida, USA
| | - Abdo R Asmar
- Department of Nephrology, University of Central Florida, Orlando, Florida, USA
| | - Fuad H Shahin
- Department of General Surgery, Osceola Surgical Associate, Kissimmee, Florida, USA
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31
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Metastases of Renal Cell Carcinoma to the Contralateral Adrenal Gland Managed by Laparoscopic Adrenalectomy. Indian J Surg Oncol 2017; 8:326-330. [DOI: 10.1007/s13193-017-0662-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 04/24/2017] [Indexed: 11/26/2022] Open
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32
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Vani M, Nambiar A, Geetha K, Kundil B. Metastatic Renal Cell Carcinoma Causing Small Intestinal Polyps with Intussusception: A Report of Two Cases. J Clin Diagn Res 2017; 11:ED13-ED15. [PMID: 28571155 DOI: 10.7860/jcdr/2017/25513.9652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 01/20/2017] [Indexed: 12/28/2022]
Abstract
Renal cell carcinomas have diverse clinical presentations. Patients may present with metastatic symptoms at the time of diagnosis or years after resection of primary tumour. Small intestine is a rare site for metastatic renal cell carcinoma. Presentation as polypoid metastasis with intussusception is extremely rare. Here, we report two cases with this rare presentation. Case 1 was a 65-year-old male with multiple polypoid metastasis causing intussusception while on palliative chemotherapy for renal cell carcinoma. Case 2 was a 68-year-old female with history of nephrectomy presenting with single polypoid metastasis causing intussusception.
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Affiliation(s)
- M Vani
- Associate Professor, Department of Pathology, Academy of Medical Sciences, Pariyaram, Kannur, Kerala, India
| | - Ajit Nambiar
- Associate Professor, Department of Pathology, Academy of Medical Sciences, Pariyaram, Kannur, Kerala, India
| | - K Geetha
- Professor and Head of Deparment, Department of Pathology, Academy of Medical Sciences, Pariyaram, Kannur, Kerala, India
| | - Byju Kundil
- Associate Professor, Department of Gastrosurgery, Academy of Medical Sciences, Pariyaram, Kannur, Kerala, India
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33
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A 57-year-old Woman With Hematuria and Headaches. Urology 2016; 102:17-20. [PMID: 27845217 DOI: 10.1016/j.urology.2016.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 10/31/2016] [Accepted: 11/02/2016] [Indexed: 11/20/2022]
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34
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Park TJ, Cho YH, Chung HS, Hwang EC, Jung SH, Hwang JE, Bae WK, Kim JW, Heo SH, Hur YH, Jung SI, Kwon DD. Prognostic significance of platelet-lymphocyte ratio in patients receiving first-line tyrosine kinase inhibitors for metastatic renal cell cancer. SPRINGERPLUS 2016; 5:1889. [PMID: 27843746 PMCID: PMC5084140 DOI: 10.1186/s40064-016-3592-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 10/21/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND The platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) have been reported as prognostic factors in various cancers, but their roles in metastatic renal cell cancer (mRCC) remain unclear. We investigated the significance of PLR and NLR, along with that of established prognostic factors, in mRCC patients receiving first-line tyrosine kinase inhibitors (TKI). METHODS Data obtained from 63 mRCC patients who received first-line TKI between 2007 and 2013 were evaluated retrospectively. The association of PLR, NLR, and established prognostic factors with progression-free survival (PFS) and overall survival (OS) was analyzed using the Kaplan-Meier method. The influence of independent prognostic factors on survival was determined using multivariable Cox regression analysis. RESULTS High NLR (>3.6) and PLR (>150) were related to shorter PFS (p = 0.001) and OS (p = 0.001). The presence of brain metastases [hazard ratio (HR) 4.94, 95% CI 1.75-13.9; p = 0.002] and high PLR (>150, HR 13.1, 95% CI 5.14-33.2; p = 0.001) were independently associated with PFS, and Eastern Cooperative Oncology Group Performance status ≥2 (HR 3.60, 95% CI 1.39-9.31; p = 0.008), lymph node metastasis (HR 2.76, 95% CI 1.11-6.86; p = 0.029), brain metastasis (HR 9.39, 95% CI 2.74-32.1; p = 0.001), and high PLR (>150, HR 16.1, 95% CI 4.41-58.4; p = 0.001) with OS. CONCLUSIONS High PLR was associated with shorter survival of mRCC patients receiving first-line TKI. The PLR may be an effective independent prognostic factor in this setting.
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Affiliation(s)
- Tae Ju Park
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757 Republic of Korea
| | - Yang Hyun Cho
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757 Republic of Korea
| | - Ho Seok Chung
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757 Republic of Korea
| | - Eu Chang Hwang
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757 Republic of Korea
| | - Sung-Hoon Jung
- Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jun Eul Hwang
- Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Woo Kyun Bae
- Department of Hemato-Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jin Woong Kim
- Department of Radiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Suk Hee Heo
- Department of Radiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Young Hoe Hur
- Department of Hepato-Pancreato-Biliary Surgery, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seung Il Jung
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757 Republic of Korea
| | - Dong Deuk Kwon
- Department of Urology, Chonnam National University Medical School, 42 Jebongro, Donggu, Gwangju, 501-757 Republic of Korea
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35
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Gajasinghe DGVDS, Nazeer I, Maddumage HP, Perera C, Abeygunasekera AM. Metachronous bladder metastases of a type 2 papillary renal cell carcinoma: a case report and review of the literature. World J Surg Oncol 2016; 14:219. [PMID: 27549183 PMCID: PMC4994218 DOI: 10.1186/s12957-016-0986-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 08/17/2016] [Indexed: 12/01/2022] Open
Abstract
Background Renal cell carcinoma developing metastases in the bladder is rare. Bladder metastasis due to a papillary type of renal cell carcinoma is rarer. Such metastases could be synchronous or metachronous. Case presentation Here we present a 55-year-old female patient with haematuria who underwent left nephro-ureterectomy for a suspected urothelial tumour. Histopathology revealed it to be a type 2 papillary renal cell carcinoma. Eighteen months later, she developed metachronous bladder metastasis of the papillary renal cell carcinoma which was treated with total cystectomy. Currently, she is on interferon therapy. Conclusions These bladder metastases from renal cell carcinoma could be due to drop metastases, lymphatic spread or haematogenous spread. The exact mechanism in a given case appears to be unpredictable.
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Affiliation(s)
| | - Ishra Nazeer
- Department of Oncological Surgery, Karapitiya Teaching Hospital, Galle, Sri Lanka
| | - Hansika P Maddumage
- Department of Pathology, Colombo South Teaching Hospital, Dehiwala, Sri Lanka
| | - Chrysantha Perera
- Department of Oncological Surgery, Karapitiya Teaching Hospital, Galle, Sri Lanka
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36
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Sirous R, Henegan JC, Zhang X, Howard CM, Souza F, Smith AD. Metastatic renal cell carcinoma imaging evaluation in the era of anti-angiogenic therapies. Abdom Radiol (NY) 2016; 41:1086-99. [PMID: 27193601 DOI: 10.1007/s00261-016-0742-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
During the last decade, the arsenal of anti-angiogenic (AAG) agents used to treat metastatic renal cell carcinoma (RCC) has grown and revolutionized the treatment of metastatic RCC, leading to improved overall survival compared to conventional chemotherapy and traditional immunotherapy agents. AAG agents include inhibitors of vascular endothelial growth factor receptor signaling pathways and mammalian target of rapamycin inhibitors. Both of these classes of targeted agents are considered cytostatic rather than cytotoxic, inducing tumor stabilization rather than marked tumor shrinkage. As a result, decreases in tumor size alone are often minimal and/or occur late in the course of successful AAG therapy, while tumor devascularization is a distinct feature of AAG therapy. In successful AAG therapy, tumor devascularization manifests on computed tomography images as a composite of a decrease in tumor size, a decrease in tumor attenuation, and the development of tumor necrosis. In this article, we review Response Evaluation Criteria in Solid Tumors (RECIST)-the current standard of care for tumor treatment response assessment which is based merely on changes in tumor length-and its assessment of metastatic RCC tumor response in the era of AAG therapies. We then review the features of an ideal tumor imaging biomarker for predicting metastatic RCC response to a particular AAG agent and serving as a longitudinal tumor response assessment tool. Finally, a discussion of the more recently proposed imaging response criteria and new imaging trends in metastatic RCC response assessment will be reviewed.
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Affiliation(s)
- Reza Sirous
- Department of Radiology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - John C Henegan
- Department of Hematology/Oncology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Xu Zhang
- Center for Biostatistics and Bioinformatics, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Candace M Howard
- Department of Radiology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Frederico Souza
- Department of Radiology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Andrew D Smith
- Department of Radiology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
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37
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Does solitary- and organ-confined metastasectomy really improve survival in advanced urologic malignancies? Int Urol Nephrol 2016; 48:671-80. [DOI: 10.1007/s11255-016-1226-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 01/22/2016] [Indexed: 10/22/2022]
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38
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Yadav S, Nayyar R, Seth A. Sequential unusual site metastases in renal cell cancer: Saga of repeated tumor implantation and prolonged survival without systemic therapy. Urol Ann 2016; 8:102-4. [PMID: 26834414 PMCID: PMC4719499 DOI: 10.4103/0974-7796.171501] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Renal cell cancer (RCC) is known to produce metastasis to unusual sites both synchronously and metachronously several years after the primary treatment. We report a rare case of RCC with three different, sequential, and each time isolated rare site metastasis to ureteric stump, surgical site, and urinary bladder over a period of 6 years after radical nephrectomy. At each recurrence, metastasectomy was carried out and no systemic therapy was administered. Eleven years after radical nephrectomy and 5 years after last resection, the patient remains disease free. Multiple recurrences can occur in RCC and complete surgical resection results in disease free survival.
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Affiliation(s)
- Siddharth Yadav
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
| | - Rishi Nayyar
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
| | - Amlesh Seth
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
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39
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Metástasis a coroides como primera manifestación de un carcinoma renal: caso clínico. REVISTA MEXICANA DE OFTALMOLOGÍA 2015. [DOI: 10.1016/j.mexoft.2015.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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40
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Abstract
It is rare for renal cell carcinoma to involve the peritoneum and cause malignant ascites. Furthermore, it is uncommon for malignant ascites to be a presenting feature of this cancer. An unusual case of renal cell carcinoma presenting with malignant ascites is reported, and its response to sunitinib described.
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Affiliation(s)
- Erica Jennison
- Departments of Gastroenterology and Histopathology, Stoke Mandeville Hospital, Aylesbury, Buckinghamshire HP21 8AL, UK
| | - Gayathri W Wathuge
- Departments of Gastroenterology and Histopathology, Stoke Mandeville Hospital, Aylesbury, Buckinghamshire HP21 8AL, UK
| | - David A Gorard
- Departments of Gastroenterology and Histopathology, Stoke Mandeville Hospital, Aylesbury, Buckinghamshire HP21 8AL, UK
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41
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Abstract
Kidney cancer incidence in the USA has been steadily increasing over the past several decades. The reasons for this are not completely clear, but an increased prevalence of known predisposing factors may be promoting this trend. Several major risk factors for kidney cancer have been identified. Among these, obesity is notable because its incidence has risen dramatically during this same period of time. Here, we will review the relationship between obesity and kidney cancer, and will explore the idea that obesity-mediated alterations in immune function may render immunotherapies for renal tumors ineffective. To support this idea, we will summarize characteristics of endogenous immune responses to renal tumors, as well as existing and developing immune-based therapies for kidney cancer patients. In doing so, we will highlight the ways in which altered immune function in obese individuals may render these therapies ineffective.
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Affiliation(s)
- Vincent Chehval
- Department of Urology, The University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
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42
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Hwang SM, Kuyava JM, Grande JP, Swetz KM. Metastatic renal cell carcinoma mimicking diverticulitis in a patient with chronic lymphocytic leukaemia. BMJ Case Rep 2015; 2015:bcr-2014-206101. [PMID: 25568267 DOI: 10.1136/bcr-2014-206101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
We present an unusual case of metastatic renal cell carcinoma (RCC) mimicking diverticulitis in a 76-year-old man with a 16-year history of chronic lymphocytic leukaemia (CLL) and a 2 cm left renal mass. The patient presented with severe abdominal pain and lower gastrointestinal bleeding with anticoagulation from recent pulmonary embolism. His clinical course was troubled by recurrent hospitalisations and complications that delayed investigations and potential treatments. Radiographic findings revealed stable CLL, mild sigmoid diverticulitis and a small renal mass. Small renal masses (less than 4 cm) are considered low risk for metastasising and are, thus, often observed or ablated, rather than resected. Furthermore, gastrointestinal metastases from RCC are rare. This case adds new perspective to the unpredictable nature of RCC and how synchronous malignancies may be masked in patients with long-standing CLL.
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Affiliation(s)
- S M Hwang
- Mayo Medical School, Rochester, Minnesota, USA
| | - J M Kuyava
- Section of Palliative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - J P Grande
- Department of Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - K M Swetz
- Section of Palliative Medicine, Mayo Clinic, Rochester, Minnesota, USA
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43
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Togral G, Arıkan M, Gungor S. Rare skeletal muscle metastasis after radical nephrectomy for renal cell carcinoma: evaluation of two cases. J Surg Case Rep 2014; 2014:rju101. [PMID: 25352576 PMCID: PMC4210763 DOI: 10.1093/jscr/rju101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Renal cell carcinomas (RCCs) commonly cause metastases to the lung, liver, bone and brain but rarely to the skeletal muscles. We describe solitary large masses located in the gluteus maximus and medius muscles in two patients who had a history of RCC treated with nephrectomy. Metastatic RCC must be distinguished from benign primary soft tissue tumors because it requires aggressive surgical resection. An open incisional biopsy revealed RCC metastasis. Both patients underwent complete resection of the large mass with additional local radiotherapy and immunochemotherapy. This incalculable course of RCC suggests the need to perform a thorough postoperative follow-up of such patients.
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Affiliation(s)
- Guray Togral
- Department of Orthopaedics and Traumatology, Oncology Training and Research Hospital, Ankara, Turkey
| | - Murat Arıkan
- Department of Orthopaedics and Traumatology, Oncology Training and Research Hospital, Ankara, Turkey
| | - Safak Gungor
- Department of Orthopaedics and Traumatology, Oncology Training and Research Hospital, Ankara, Turkey
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44
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Dolanbay M, Kutuk MS, Uludag S, Ozgun MT, Ozturk F, Ozcelik B. A case of renal cell carcinoma with solitary metastasis to the ovary. J OBSTET GYNAECOL 2014; 35:218-9. [PMID: 25141223 DOI: 10.3109/01443615.2014.948814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- M Dolanbay
- Department of Obstetrics and Gynecology, Faculty of Medicine, Erciyes University, Gevher Nesibe Hospital , Kayseri , Turkey
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45
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Brufau BP, Cerqueda CS, Villalba LB, Izquierdo RS, González BM, Molina CN. Metastatic renal cell carcinoma: radiologic findings and assessment of response to targeted antiangiogenic therapy by using multidetector CT. Radiographics 2014; 33:1691-716. [PMID: 24108558 DOI: 10.1148/rg.336125110] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Recent advances in treatment of metastatic renal cell carcinoma (RCC), such as new molecular therapies that use novel antiangiogenic agents, have led to revision of the most frequently used guideline to evaluate tumor response to therapy: Response Evaluation Criteria in Solid Tumors (RECIST 1.1). Assessment of the response of metastatic RCC to therapy has traditionally been based on changes in target lesion size. However, the mechanism of action of newer antiangiogenic therapies is more cytostatic than cytotoxic, which leads to disease stabilization rather than to tumor regression. This change in tumor response makes RECIST 1.1--a system whose criteria are based exclusively on tumor size--inadequate to discriminate patients with early tumor progression from those with more progression-free disease and prolonged survival. New criteria such as changes in attenuation, morphology, and structure, as seen at contrast-enhanced multidetector computed tomography (CT), are being incorporated into new classifications used to assess response of metastatic RCC to antiangiogenic therapies. The new classifications provide better assessments of tumor response to the new therapies, but they have some limitations. The authors provide a practical review of these systems--the Choi, modified Choi, and Morphology, Attenuation, Size, and Structure (MASS) criteria--by explaining their differences and limitations that may influence the feasibility and reproducibility of these classifications. The authors review the use of multidetector CT in the detection of metastatic RCC and the different appearances and locations of these lesions. They also provide an overview of the new antiangiogenic therapies and their mechanisms of action and a brief introduction to functional imaging techniques. Functional imaging techniques, especially dynamic contrast-enhanced CT, seem promising for assessing response of metastatic RCC to treatment. Nonetheless, further studies are needed before functional imaging can be used in routine clinical practice.
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Affiliation(s)
- Blanca Paño Brufau
- CDIC and ICMHO, Hospital Clínic de Barcelona, C/Villarroel n° 170, 08036 Barcelona, Spain
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Dong X, Kong C, Zhang Z, Liu X, Zhan B, Chen Z, Shi D. hZIP1 that is down-regulated in clear cell renal cell carcinoma is negatively associated with the malignant potential of the tumor. Urol Oncol 2014; 32:885-92. [PMID: 24878177 DOI: 10.1016/j.urolonc.2014.02.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 02/24/2014] [Accepted: 02/25/2014] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The human ZRT, IRT-like protein 1 (hZIP1) has been associated with tumorigenesis. However, its role in clear cell renal cell carcinoma (ccRCC) has not been yet reported. The objective was to investigate hZIP1 expression in ccRCC and its association with clinicopathological features. MATERIALS AND METHODS A total of 106 ccRCC tissue samples and corresponding normal kidney tissue samples were examined, along with 3 ccRCC cell lines (ACHN, 769-P, and 786-O). Real-time polymerase chain reaction, Western blot, and immunohistochemistry were used to investigate the expression of hZIP1 and its relationship with clinicopathological features. The ACHN cell line, exhibiting the highest hZIP1 expression, was transfected with hZIP1 small interfering RNA or mock small interfering RNA. Cellular proliferation was measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Invasion was determined by Transwell assay. RESULTS The level of hZIP1 was decreased in ccRCC tissues when compared with normal tissues. hZIP1 expression significantly decreased with increasing clinical stage and pathological grade in ccRCC samples (P<0.05), showing a significant negative correlation with the histological grade (P<0.05). High hZIP1 expression was associated with a better disease-free survival (P<0.01). Silencing of hZIP1 expression enhanced the proliferative and invasive abilities of ACHN cells. CONCLUSIONS Results suggest that hZIP1 may act as a tumor suppressor in ccRCC. hZIP1 is closely correlated with clinicopathological features. High hZIP1 expression may be an indicator of good prognosis in ccRCC.
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Affiliation(s)
- Xiao Dong
- Department of Urology, the First Hospital of China Medical University, Shenyang, People׳s Republic of China
| | - Chuize Kong
- Department of Urology, the First Hospital of China Medical University, Shenyang, People׳s Republic of China.
| | - Zhe Zhang
- Department of Urology, the First Hospital of China Medical University, Shenyang, People׳s Republic of China
| | - Xiankui Liu
- Department of Urology, the First Hospital of China Medical University, Shenyang, People׳s Republic of China
| | - Bo Zhan
- Department of Urology, the First Hospital of China Medical University, Shenyang, People׳s Republic of China
| | - Zhipeng Chen
- Department of Urology, the First Hospital of China Medical University, Shenyang, People׳s Republic of China
| | - Du Shi
- Department of Urology, the First Hospital of China Medical University, Shenyang, People׳s Republic of China
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Rita H, Isabel A, Iolanda C, Alexander H, Pedro C, Liliana C, Lucília M, Sofia S, Leopoldo M. Treatment of gastric metastases from renal cell carcinoma with endoscopic therapy. Clin J Gastroenterol 2014; 7:148-54. [DOI: 10.1007/s12328-014-0470-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 02/20/2014] [Indexed: 12/23/2022]
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Tatsui CE, Suki D, Rao G, Kim SS, Salaskar A, Hatiboglu MA, Gokaslan ZL, McCutcheon IE, Rhines LD. Factors affecting survival in 267 consecutive patients undergoing surgery for spinal metastasis from renal cell carcinoma. J Neurosurg Spine 2014; 20:108-16. [PMID: 24206037 DOI: 10.3171/2013.9.spine13158] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECT Renal cell carcinoma (RCC) frequently metastasizes to the spine, and the prognosis can be quite variable. Surgical removal of the tumor with spinal reconstruction has been a mainstay of palliative treatment. The ability to predict prognosis is valuable when determining the role and magnitude of surgical intervention in cancer patients. To better identify factors affecting survival in patients undergoing surgery for spinal metastasis from RCC, the authors undertook a retrospective analysis of a large patient cohort at a tertiary care cancer center. METHODS Relevant clinical data on a consecutive series of patients who had undergone surgery for spinal metastasis of RCC between 1993 and 2007 at The University of Texas MD Anderson Cancer Center were retrospectively reviewed. Demographic data, histopathological grade of primary tumor, timing of spinal surgery relative to diagnosis, treatment history prior to surgery, neurological status, and systemic disease burden were analyzed to determine the impact of these factors on survival outcome. RESULTS The authors identified 267 patients who met the study criteria. Five-year overall survival (OS) after spine tumor resection was 7.8%, with a median OS of 11.3 months (95% CI 9.5-13.0 months). Patients with Fuhrman Grade 4 RCC had a median OS of 6.1 months (95% CI 3.5-8.7 months), which was significantly lower than the 14.3 months (95% CI 9.1-19.4 months) observed in patients with Fuhrman Grade 3 or less RCC (p < 0.001). Patients with preoperative neurological deficits had a median survival of 5.9 months (95% CI 4.1-7.7 months), which was significantly lower than the 13.5 months (95% CI 10.4-16.6 months) observed in patients with a normal neurological examination (p < 0.001). Patients whose spine was the only site of metastasis had a median OS of 19 months (95% CI 9.8-28.2 months) after surgery, significantly longer than the 9.7 months (95% CI 8.1-11.3 months) observed in patients with additional extraspinal metastasis sites (p < 0.001). Patients with nonprogressing extraspinal metastasis (no metastasis, stable, or concurrent) had a median survival of 20.6 months (95% CI 15.1-26.1 months), compared with 5.6 months (95% CI 4.4-6.8 months) in patients with progressing metastasis (p < 0.001). CONCLUSIONS The authors identified several factors influencing survival after spine surgery for metastatic spinal RCC, including grade of the original nephrectomy specimen, activity of the systemic disease, and neurological status at the time of surgery. These clinical features may help to identify patients who may benefit from aggressive surgical intervention.
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Affiliation(s)
- Claudio E Tatsui
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Metastatic renal cell carcinoma in an ovarian benign mixed mucinous cystadenoma and brenner tumour: a case report. Case Rep Pathol 2012; 2012:523231. [PMID: 23227402 PMCID: PMC3514817 DOI: 10.1155/2012/523231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 10/22/2012] [Indexed: 12/28/2022] Open
Abstract
This is a case of a 71-year-old woman, who presented with a large abdominal mass. Microscopic examination revealed metastatic renal cell carcinoma in an otherwise massively enlarged benign ovarian tumour of mixed mucinous cystadenoma and Brenner tumour. Clinicopathological and radiological assessment together with a thorough evaluation of gross and histological features, including the use of immunohistochemical stains, is essential to confirm the diagnosis and rule out the possibility of primary clear cell carcinoma of ovary, as this has important prognostic and therapeutic implications.
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Priluck JC, Grover S, Chalam K. Meridional lenticular astigmatism associated with bilateral concurrent uveal metastases in renal cell carcinoma. Clin Ophthalmol 2012; 6:1839-41. [PMID: 23152663 PMCID: PMC3497461 DOI: 10.2147/opth.s37163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To demonstrate a case illustrating meridional lenticular astigmatism as a result of renal cell carcinoma uveal metastases. Methods Case report with images. Results Clinical findings and diagnostic testing of a patient with acquired meridional lenticular astigmatism are described. The refraction revealed best-corrected visual acuity of 20/20–1 OD (−2.50 + 0.25 × 090) and 20/50 OS (−8.25 + 3.25 × 075). Bilateral concurrent renal cell carcinoma metastases to the choroid and ciliary body are demonstrated by utilizing ultrasonography, ultrawidefield fluorescein angiography, and unique spectral-domain optical coherence tomography. Conclusions Metastatic disease should be included in the differential of acquired astigmatism. Spectral-domain optical coherence tomography, ultrawidefield fluorescein angiography, and ultrasonography have roles in delineating choroidal metastases.
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Affiliation(s)
- Joshua C Priluck
- Department of Ophthalmology, University of Florida College of Medicine, Jacksonville, FL, USA
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