1
|
Wasifuddin M, Ilerhunmwuwa N, Hakobyan N, Sedeta E, Uche I, Aiwuyo HO, Perry JC, Heravi O, Boris A. Malignant Pleural Effusion As the Initial Presentation of Renal Cell Carcinoma: A Case Report and Literature Review. Cureus 2023; 15:e37128. [PMID: 37153237 PMCID: PMC10159591 DOI: 10.7759/cureus.37128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2023] [Indexed: 05/09/2023] Open
Abstract
Renal cell carcinoma is the most common renal neoplasm. Its presentation is often very occult, and it may be discovered incidentally. It may present with the classic symptoms of back pain, flank pain, hematuria, or hypertension. Renal cell carcinoma may also present with malignant pleural effusion at diagnosis; however, it is very rare. In this case report and literature review, we describe a 77-year-old male who was diagnosed with renal cell carcinoma after presenting with a malignant pleural effusion - an extremely rare phenomenon. An analysis of the literature yielded 13 case reports, including ours, where the diagnostic presentation of renal cell carcinoma was a malignant pleural effusion. Our patient presented with left-sided chest pain. Imaging was suggestive of pleural effusion. CT and MRI imaging demonstrated masses in the upper and lower poles of the right kidney suggestive of renal cell carcinoma. CT imaging also showed lung nodules that were suggestive of pulmonary metastases. Biopsy and immunostaining of pleural tissue were positive for clear cell renal cell carcinoma. Therapeutic thoracentesis was performed. Despite this, the patient developed recurrent large-volume pleural effusions requiring drainage and placement of a pleural catheter. Our patient's extremely rare presentation of malignant pleural effusion as the diagnostic presentation of renal cell carcinoma along with recurrent, large-volume effusions requiring drainage has only been reported in the form of case reports in the literature.
Collapse
Affiliation(s)
- Mustafa Wasifuddin
- Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, USA
| | | | - Narek Hakobyan
- Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, USA
| | - Ephrem Sedeta
- Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, USA
| | - Ifeanyi Uche
- Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, USA
| | - Henry O Aiwuyo
- Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, USA
| | - Jamal C Perry
- Medicine, Brookdale University Hospital Medical Center, Brooklyn, USA
| | - Omid Heravi
- Oncology, Brookdale University Hospital Medical Center, Brooklyn, USA
| | - Avezbakiyev Boris
- Hematology/Oncology, Brookdale University Hospital Medical Center, Brooklyn, USA
| |
Collapse
|
2
|
Saito Z, Hata K, Nishioka S, Tamura K, Tamura N, Yoshida M, Kasa K, Hirano J, Masubuchi M, Kuwano K. Localized pleural metastasis without other organ metastases after nephrectomy for renal cell carcinoma. Respir Med Case Rep 2021; 33:101388. [PMID: 33854938 PMCID: PMC8025045 DOI: 10.1016/j.rmcr.2021.101388] [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: 11/24/2020] [Revised: 02/15/2021] [Accepted: 03/15/2021] [Indexed: 11/18/2022] Open
Abstract
We present a case of a 69-year-old man who had localized pleural metastasis without other organ metastases after nephrectomy for right renal cell carcinoma (RCC). He complained of respiratory symptoms for more than two years after the operation and was confirmed to have right pleural effusion and multiple pleural masses on computed tomography (CT). There were no abnormal findings in the other organs, but the pleural mass gradually increased in size on CT. We suspected malignant tumors such as malignant pleural mesothelioma and synovial sarcoma in addition to RCC metastasis. Finally, we performed surgical resection of the pleural mass under general anesthesia, and we diagnosed pathologically as metastasis from RCC. Distant metastases of RCC are common in the lungs, bones, brain, and liver. To our knowledge, localized pleural metastases from RCC is rare.
Collapse
Affiliation(s)
- Zenya Saito
- Division of Respiratory Diseases, Department of Internal Medicine, Atsugi City Hospital, Kanagawa, Japan
- Corresponding author. Division of Respiratory Diseases, Department of Internal Medicine, Atsugi City Hospital, 1-16-36 Mizuhiki, Atsugi-shi, Kanagawa, 243-8588, Japan.
| | - Kenichi Hata
- Department of Urology, Atsugi City Hospital, Kanagawa, Japan
| | - Saiko Nishioka
- Division of Respiratory Diseases, Department of Internal Medicine, Atsugi City Hospital, Kanagawa, Japan
| | - Kentaro Tamura
- Division of Respiratory Diseases, Department of Internal Medicine, Atsugi City Hospital, Kanagawa, Japan
| | - Nobumasa Tamura
- Division of Respiratory Diseases, Department of Internal Medicine, Atsugi City Hospital, Kanagawa, Japan
| | - Masahiro Yoshida
- Division of Respiratory Diseases, Department of Internal Medicine, Atsugi City Hospital, Kanagawa, Japan
| | - Kentaro Kasa
- Department of Surgery, Atsugi City Hospital, Kanagawa, Japan
| | - Jun Hirano
- Division of Thoracic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | | | - Kazuyoshi Kuwano
- Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| |
Collapse
|
3
|
Kataoka M, Yata Y, Nose S, Yasuda K, Ohara T. Solitary pleural metastasis from renal cell carcinoma: a case of successful resection. Surg Case Rep 2015; 1:36. [PMID: 26366340 PMCID: PMC4560145 DOI: 10.1186/s40792-015-0039-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 04/09/2015] [Indexed: 11/10/2022] Open
Abstract
While renal cell carcinoma frequently metastasizes to the lung, solitary pleural metastasis without lung involvement is extremely rare. A 69-year-old man was admitted to our hospital with a solitary pleural metastasis 6 years after surgery for renal cell carcinoma. Needle biopsy was performed, and the tumor was diagnosed as a metastasis of renal cell carcinoma. The pleural tumor was surgically resected. The patient received interferon-α as postoperative therapy. He has been alive for 9 years without recurrence. Only 11 cases of solitary pleural metastasis have been reported thus far, and of these, 7 involved a large amount of pleural effusion resulting in a poor prognosis. This is the first reported case of solitary pleural metastasis from renal cell carcinoma, which was curatively resected, as indicated by long-term survival.
Collapse
Affiliation(s)
- Masafumi Kataoka
- Department of Surgery, Okayama Saiseikai General Hospital, 1-17-18 Ifukucho, Kita-ku, Okayama City, 700-8511 Japan
| | - Yuji Yata
- Department of Surgery, Okayama Saiseikai General Hospital, 1-17-18 Ifukucho, Kita-ku, Okayama City, 700-8511 Japan
| | - Sohichiro Nose
- Department of Pathology, Okayama Saiseikai General Hospital, 1-17-18 Ifukucho, Kita-ku, Okayama City, 700-8511 Japan
| | - Koichiro Yasuda
- Department of Surgery, Okayama Saiseikai General Hospital, 1-17-18 Ifukucho, Kita-ku, Okayama City, 700-8511 Japan
| | - Toshinori Ohara
- Department of Surgery, Okayama Saiseikai General Hospital, 1-17-18 Ifukucho, Kita-ku, Okayama City, 700-8511 Japan
| |
Collapse
|