Metachronous contralateral testicular and bilateral adrenal metastasis of chromophobe renal cell carcinoma: a case report and review of the literature

Abstract

Chromophobe renal cell carcinoma (ChRCC) metastatic to the testis has not, to the best of our knowledge, been reported in the literature. Nor have there been reports of delayed bilateral adrenal metastasis of ChRCC. Here we report a case of metachronous contralateral testicular and bilateral adrenal metastasis of ChRCC in a 70-year-old man who underwent right radical nephrectomy for RCC six years ago. He was admitted to the hospital because of left intrascrotal enlargement of two-month duration. Ultrasonography revealed a mass in the upper pole of the left testis. Computed tomography (CT) showed irregular masses in the bilateral adrenal area. Left radical orchiectomy and laparoscopic bilateral adrenalectomy were performed. The pathologic examination showed metastatic ChRCC in the left testis and bilateral adrenal gland. Postoperative follow-up showed that the patient had survived for at least 56 months without recurrence. The case highlights the unique behavior of RCC with an unusual site of metastasis and favorable survival after multiple metastasectomy.

A Rare Case of the Simultaneous, Multifocal, Metastatic Renal Cell Carcinoma to the Ipsilateral Left Testes, Bladder, and Stomach

“…The time to metastasis generally occurs years beyond primary cancer presentation. In testicular metastasis, it usually occurs simultaneously or precedes the diagnosis of renal tumors [ 4 ]. We report a rare case of simultaneous presentation of RCC metastasis to the stomach, bladder, and ipsilateral left testicle 7 years after left nephrectomy for clear cell renal cell carcinoma (RCC).…”

Radikal nefrektomi sonrası kontralateral soliter adrenal metastaz: Olgu sunumu

“…Bu tedavi ile operasyon sonrası ortaya çıkabilecek akut adrenal yetmezlik durumunun önüne geçilmiş olacaktır [13]. Biz hastamıza endokrinoloji önerisi ile operasyon önce-si, operasyon sırasında ve operasyon sonrası 20 mg intravenöz metil prednizolon tedavisi başlayıp daha sonra idame tedavisi uyguladık.…”

Metastatic renal cell carcinoma to the testis: A case report and review of the literature

“…6 In our review of the literature, we identified 27 cases of metastatic RCC to the testes in the English language, and in all except for one, they were clear cell carcinomas. [5][6][7][8][9][10][11] In most cases, patients were between the sixth and seventh decade, 5,7-9 although in one publica- …”

“…Even in those having been previously treated for renal malignancy, disease relapse has present as recurrences in the testicle. 7 Thus, when evaluating an elderly patient with a testicular mass, the possibility of metastatic disease must be considered in the differential diagnosis, especially in the setting of suspected or remote malignancy.…”

“…From our review of the available data, we found that there were at least 7 cases with contralateral involvement reported in the literature, including our case above. [5][6][7][8][9][10][11] Even with many reports, the mechanisms of metastasis is still unclear; however, there are suggestions of spread via Batson's venous complex. 9,11,13 This avalvular venous network may provide the necessary conduit between contralateral renal capsular veins and spermatic cord ves- Metastatic rcc to the testis sels, thus potentially explaining distant seeding from a right RCC to a left testicle, as in our case above.…”