Metachronous metastasis to contralateral retroperitoneal adipose tissue after radical nephrectomy: a case report and review of the literature

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.

Application of the indocyanine green fluorescence imaging method in laparoscopic resection of a solitary retroperitoneal metastasis of renal cell carcinoma: A case report

“…Renal cell carcinoma (RCC) metastasis to the ipsilateral retroperitoneal space is relatively common 1 . However, after radical nephrectomy, it is difficult to identify the anatomical relative position of the small recurrent tumor in the retroperitoneal space during surgery because there are no landmark organs.…”

Solitary Metachronous Chest Wall Metastasis of a Clear-cell Renal Cell Carcinoma 13 Years after Radical Nephrectomy

“…According to the literature, 20-40% of patients with RCC experience metastasis or recurrence after radical nephrectomy. 1 , 2 Approximately 45-60% of RCC metastasizes to the lung, with other common sites including the lymph nodes, spine, liver, and adrenal glands. 3 , 4 Atypical metastasis sites, such as the sternum and myocardium, have also been reported.…”