Management of Very Late Pancreatic Metastasis of Renal Cell Carcinoma 8 Years After Radical Nephrectomy: A Report of a Rare Case

Alayyaf, Norah; AlQatari, Abdullah Abdulaziz; Altalib, Amer; AlQattan, Abdullah Saleh; Alshahrani, Abdullah

doi:10.12659/ajcr.927921

Cited by 3 publications

(1 citation statement)

References 9 publications

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“…Alayyaf et al . report a case with very late pancreatic metastasis of RCC 8 years after radical nephrectomy [ 15 ]. Their patient was asymptomatic and underwent a spleen-preserving distal pancreatectomy.…”

Section: Discussionmentioning

confidence: 99%

Renal cell carcinoma with unusual metachronous metastasis up to 22 years after nephrectomy: two case reports

Bruckschen¹,

Gerharz²,

Sagir³

2021

J Med Case Reports

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Introduction Renal cell carcinoma is the third most common malignant tumor in the urogenital tract. An estimated 25% of renal cell carcinomas are in stage IV when diagnosed. The 5-year-survival with stage IV is about 20%. Late metastases are found after an extended disease-free interval up to 20 years after primary nephrectomy. Case presentation Here, we present two cases with late-onset metastasis of renal cell carcinoma with different clinical presentations. The first patient, an 88-year-old Caucasian man, presented with bleeding of the upper gastrointestinal tract. Biopsies taken from the duodenal bulb showed a tumor compatible with a solitary metastasis from renal cell carcinoma 22 years ago. The second patient, a 79-year-old Caucasian man, consulted our gastroenterological department with results of an outpatient computed tomography scan with multiple suspected tumor areas in the liver, omentum, thyroid, and mediastinum. A computed tomography-guided liver biopsy was performed that showed a clear-cell tumor consistent with a metastasis of the renal cell carcinoma 17 years ago. Conclusion Both cases show that patients with a history of renal cell carcinoma should be followed up for a longer time than patients with other malignant tumors.

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Section: Discussionmentioning

confidence: 99%

Renal cell carcinoma with unusual metachronous metastasis up to 22 years after nephrectomy: two case reports

Bruckschen¹,

Gerharz²,

Sagir³

2021

J Med Case Reports

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Late progression of renal cell carcinoma after 32 years: clinical case

Petrov,

Izmailov,

Ustimenko

et al. 2024

Onkourologiâ

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In 2022, renal cell carcinoma was the 10th (3.9 %) most common cancer in the Russian Federation. According to the World Health Organization, in 2020 431,288 new cases of kidney cancer were detected worldwide, and by 2040 the incidence will increase up to 605,726 cases. Local recurrence of the disease develops in 1.8–14.6 % of patients with localized and locally advanced kidney cancer who underwent radical nephrectomy. Surgery, if technically possible, is the gold standard for the treatment of patients with solitary or single (≤2) metastases of any location, and in most cases, it requires aggressive tactics.Many large randomized trials have investigated adjuvant therapy using targeted drugs for renal cell carcinoma but no statistically significant differences in risk of death and progression irrespective of the drugs used or treatment duration has been shown. Currently, only the KEYNOTE-564 randomized trial has demonstrated an increase in recurrencefree survival in patients with intermediate-high and high risk renal cell carcinoma.The article presents a clinical case of late progression of renal cell carcinoma in extraperitoneal lymph nodes 32 years after combination treatment (radical nephrectomy + external beam radiotherapy on the bed of the resected kidney).

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Isolated Pancreatic Metastases of Renal Cell Carcinoma—Clinical Particularities and Seed and Soil Hypothesis

Sellner

Thalhammer

Klimpfinger

2023

Cancers

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A meta-analysis of 1470 isolated pancreatic metastases of renal cell carcinoma revealed, that, in addition to the unusual exclusive occurrence of pancreatic metastases and the favourable treatment results, the isPMRCC is characterised by further peculiarities of the clinical course: The lack of prognostic significance of volume and growth rate dependent risk factors and the independence of treatment results from standard or local resections. As an explanation for all these peculiarities, according to today’s knowledge, a strong acting seed and soil mechanism can serve, which allows embolized tumour cells to grow to metastases only in the pancreas, and prevents them definitively or for years in all other organs. The good prognosis affects not only isolated PM, but also multi-organ metastases of the RCC, in which the additional occurrence of PM is also associated with a better prognosis. Genetic studies revealed specific changes in cases of PM of RCC: Lack of loss of 9p21.3 and 14q31.2, which are otherwise specific gene mutations at the onset of generalization, a low weight genome instability index, i.e., high genetic stability, and a low rate of PAB1 and a high rate of BPRM1 alterations, which signal a more favourable course. The cause of pancreatic organotropism in isPMRCC is still unclear, so only those factors that have been identified as promoting organotropism in other, more frequent tumour entities can be presented: Formation of the pre-metastatic niche, chemokine receptor–ligand mechanism, ability to metabolic adaptation, and immune surveillance.

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Management of Very Late Pancreatic Metastasis of Renal Cell Carcinoma 8 Years After Radical Nephrectomy: A Report of a Rare Case

Cited by 3 publications

References 9 publications

Renal cell carcinoma with unusual metachronous metastasis up to 22 years after nephrectomy: two case reports

Renal cell carcinoma with unusual metachronous metastasis up to 22 years after nephrectomy: two case reports

Late progression of renal cell carcinoma after 32 years: clinical case

Isolated Pancreatic Metastases of Renal Cell Carcinoma—Clinical Particularities and Seed and Soil Hypothesis

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