Autopsy results after surgery for non-small cell lung cancer

A rare case of isolated lung metastasis in the kidney

Renal metastases are very rare condition in the clinical practice. The treatment is individualized and it depends on general status of the patient, involving of other organs and also the control of primary tumor. We are presenting a 64 years old woman, who had episodes of intermittent hematuria for two weeks. CT scan showed a large heterogeneous left kidney mass. The patient underwent open transabdominal radical left nephrectomy and the final diagnosis was isolated lung adenocarcinoma metastasis of the kidney.

Solitary renal metastasis from squamous cell carcinoma of the lung: A case report

RATIONALE

Non-small cell cancer with isolated unilateral renal metastasis is rare, and the role of radical nephrectomy has not been determined. In the present study, a case of a patient with solitary kidney metastasis from squamous cell lung cancer who underwent radical nephrectomy is reported.

PATIENT CONCERNS

A 74-year-old patient diagnosed with pulmonary squamous cell lung cancer who had undergone radical pulmonary lobectomy and mediastinal lymph node dissection revealed a solitary mass in the right kidney during the follow-up.

DIAGNOSES

Unilateral isolated kidney metastasis originated from squamous cell lung cancer.

INTERVENTIONS

The patient underwent radical right nephrectomy and squamous cell cancer metastasis was confirmed by the postoperative pathology results.

OUTCOME

Lung cancer relapse was diagnosed and the patient died of cancer progression 10 months after the right nephrectomy.

LESSONS

Solitary renal metastasis is rare and squamous cell lung cancer might be the primary disease. Abdominal computed tomography (CT) is important in detecting solitary kidney metastasis during the follow up of patients with squamous cell lung cancer. Due to the rareness of isolated renal metastasis, the role of radical nephrectomy needs to be further investigated.

Isolated Renal Metastasis from Non-Small-Cell Lung Cancer: Report of 2 Cases

Renal metastasis from non-small-cell lung cancer is rather uncommon; isolated metastasis especially is rare. Herein we report 2 cases who developed a solitary renal metastasis after undergoing a curative resection for non-small-cell lung cancer. They received nephrectomy.

Adrenal metastases in lung cancer: clinical implications of a mathematical model

Adrenal gland metastases are common in lung cancer. It is well recognized that aggressive treatment of solitary adrenal metastases leads to improved outcomes but the exact nature of adrenal deposits is not well understood. Controversy exists as to the routing of cancer cells to the adrenal gland with some believing that this transmission is lymphatic, in contrast to the more generally accepted theory of hematogenous spread. Recently published mathematical modeling of cancer progression strongly supports the lymphatic theory. With that in mind, we performed a literature review to look for biological plausibility of simulation results and believe that evidence supports the contention that metastases to the adrenal gland can be routed by means of lymphatic channels. This could explain improved survival for patients in whom solitary adrenal metastases are managed aggressively with surgical or radiation modalities. We are calling for clinical trials prospectively testing this hypothesis.

Isolated renal metastasis from squamous cell lung cancer

Renal metastasis from non-small cell lung cancer is rather uncommon. The mechanism underlying the occurrence of metastasis in this site is still not well understood. We report a case of a 53-year-old Chinese woman who had moderately differentiated squamous cell carcinoma of the lung. After a ten months post-surgery interval of disease free survival, computed tomography (CT) scan found that left renal parenchymal was occupied by a mass, confirmed by kidney biopsy to be a metastasis from squamous cell lung carcinoma. Based on this case, we are warned to be cautious in diagnosis and treatment when renal lesion are detected.

Problems in pathologic staging of lung cancer

CONTEXT

Tumor stage is the most important prognostic and predictive factor for patients with lung cancer, the most lethal neoplasm in the United States. It is used by thoracic surgeons, radiation therapists, and oncologists to determine whether patients with these neoplasms will be treated surgically with curative intent or with palliative radiation therapy and/or chemotherapy.

OBJECTIVE

To review the variety of practical problems that can arise during the assessment of the pathologic stage and other prognostic/predictive factors included in the College of American Pathologist checklist for evaluation of resected lung neoplasms.

DATA SOURCES

Potential practical difficulties that can arise during the pathologic staging of lung cancer patients include the distinction between pT1, pT2, and pT3 lesions based on their location and the presence of visceral pleura and/or parietal pleura invasion; the differential diagnosis between multiple synchronous or metachronous primary lung neoplasms (pT1m) and intrapulmonary metastasis of non-small cell carcinoma of the lung (pT4 or pM1 according to their location); and the role of the recent American Joint Committee on Cancer terminology for the classification of lymph nodes (isolated tumor cells, micrometastases, and metastases).

CONCLUSIONS

The variety of practical problems that can arise during the assessment of important prognostic and predictive features such as resection margin status and evaluation of lymphovascular invasion are reviewed. A brief discussion of the assessment of the effects of neoadjuvant therapy on resected lung neoplasms is also included.