Metastatic Clear Cell Renal Cell Carcinoma Presenting as Multiple Colonic Polyps

Chetty, Runjan; Syed, A S; Kwast, Theodorus H. van der

doi:10.1177/1066896909333750

Cited by 4 publications

(9 citation statements)

References 16 publications

(27 reference statements)

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“…Rectal clear cell carcinoma shows cytokeratin (CK)20 positivity and CK7 negativity. In comparison, RCC is only positive for CD10 and vimentin [ 9 ]. This was the case in our patient, whose histology and staining patterns were consistent with metastatic renal clear cell carcinoma from his native kidneys.…”

Section: Discussionmentioning

confidence: 99%

Delayed Metastasis of Clear Cell Renal Carcinoma to the Colon in the Setting of Benign Kidney Disease

Tagliaferri¹,

Costanzo²

2022

Cureus

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Clear cell renal carcinoma (CCRC) is a common variant of renal cell carcinoma (RCC), which presents with unpredictable features. The occurrence of RCC in those with autosomal dominant polycystic kidney disease (ADPKD) is debated. Most studies agree that ADPKD does not increase the risk of RCC; however, it makes diagnosing RCC difficult due to the nature of the disease. RCC frequently metastasizes to the lungs, lymph nodes, bones, liver, adrenal glands, and brain, but rarely metastasizes to the colon. In all previous reports, primary RCC was already diagnosed in the kidneys; thus, metastatic CCRC to the colon has never been described in the current literature in the absence of a primary renal tumor.Here, we report a rare presentation of metastatic CCRC wherein a patient with ADPKD presented with an obstructing sigmoid mass six years after bilateral nephrectomy for pathologically benign cysts. Despite a close follow-up after nephrectomy, our patient's non-specific symptoms were attributed to underlying comorbidities and more likely etiologies of back pain, diarrhea, and anemia, thus delaying and complicating the diagnosis of CCRC which subsequently led to metastases at the time of presentation.Although past literature has described CCRC metastases to other parts of the gastrointestinal tract or even described primary clear cell carcinoma of the colon, this is the first case in which a patient with benign cystic renal disease developed CCRC presenting as metastatic disease of the colon, rectum, liver, and lung. This paper will address the manifestations of ADPKD and postulate mechanisms for the unpredictable nature of this patient's RCC metastasis.

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Section: Discussionmentioning

confidence: 99%

Delayed Metastasis of Clear Cell Renal Carcinoma to the Colon in the Setting of Benign Kidney Disease

Tagliaferri¹,

Costanzo²

2022

Cureus

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“…On literature review, not surprisingly, the most common metastatic type of RCC to GI tract is clear cell type, the commonest RCC subtype [46]. However, papillary type, chromophobe type and sarcomatoid type RCC metastasizing to colon have been reported [37,47,48].…”

Section: Discussionmentioning

confidence: 99%

“…Jadav et al [ 22 ] 67 Y/F Abdominal pain Transverse colon 9 years Clear cell 14. Chetty [ 23 ] 92 Y/M Asymptomatic Ascending and sigmoid colon 17 years Clear cell 15. Zhao et al [ 24 ] 54 Y/M Hematochezia Ascending colon At time of diagnosis Chromophobe 16.…”

Section: Introductionmentioning

confidence: 99%

Metastatic renal cell carcinoma to pancreas and gastrointestinal tract: a clinicopathological study of 3 cases and review of literature

et al. 2021

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Background Renal Cell Carcinoma (RCC) metastasizes in approximately 20–30% cases. The most common sites for metastases are the lungs, bones, liver, and brain. Metastases of RCC in the gastrointestinal tract (GIT) are very rare. Metastatic RCC has a poor prognosis. We herein present a case series of three patients with metastatic disease in the colon, duodenum, and pancreas following complete resection of RCC. Methods Hematoxylin and Eosin and immunohistochemical slides of 3 cases of RCC metastatic to GIT were reviewed. These cases were diagnosed between 2002 and 2019 at French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan, and Aga Khan University Hospital (AKUH), Karachi, Pakistan. We also present a detailed review of published literature. Results We reviewed cases of three patients, two females and one male, with a mean age of 57.3 years (range 40–67 years) who underwent nephrectomy for RCC. They developed metastases in the colon, pancreas, and duodenum, respectively 12–168 months (median time 156 months) following primary tumor resection. The patient with metastatic RCC in colon presented with abdominal pain and constipation. An ulcerated mass was found on colonoscopy 30 cm from the anal verge. Diagnosis of RCC with rhabdoid features was confirmed in both primary and metastatic tumors. The second patient developed a metastatic nodule in the head of pancreatic while the third patient developed metastatic nodules in the duodenum and pancreas which were detected by Computed Tomography (CT) scanning. Histopathological examination confirmed the presence of clear cell RCC in the metastatic nodules in both cases. Conclusion Metastatic RCC should be considered in the differential diagnosis of mass in the gastrointestinal (including pancreaticobiliary) tract especially in presence of a past history of RCC. These patients should be screened thoroughly by physical examination and appropriate imaging studies.

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“…Other unusual metastatic sites of RCC include colon, intestine, stomach, pancreas, gallbladder, prostate, thyroid gland, and skeletal muscle. [7–11] These rare metastatic sites were usually accompanied by multiple metastasis in the whole body, and the period from the initial diagnosis of RCC to metastasis may range from several years to more than 10 years.…”

Section: Discussionmentioning

confidence: 99%

Metastatic renal clear cell carcinoma to the rectum, lungs, ilium, and lymph nodes

Zheng

Li²,

Li³

et al. 2017

Medicine

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Background:Renal cell carcinoma metastasizing to rectum is very rare, and the unusual metastatic sites should be paid attention to during the follow-up of renal cell carcinoma.Case summary:We describe a case of a 65-year-old male who was diagnosed with metastatic renal cell carcinoma to rectum 10 years after the right radical nephrectomy. Histopathology and immunohistochemical examinations contribute to making differential diagnosis between rectal metastasis of renal cell carcinoma and primary rectal clear cell carcinoma. Positron emission tomography-computed tomography with fluorodeoxyglucose shows hypermetabolic activity in upper rectum and other sites of metastasis at the same time.Conclusion:Possibility of unusual metastatic sites of renal cell carcinoma such as rectum indeed exists, which should not be ignored in the surveillance after resection of the primary tumor.

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Metastatic Clear Cell Renal Cell Carcinoma Presenting as Multiple Colonic Polyps

Cited by 4 publications

References 16 publications

Delayed Metastasis of Clear Cell Renal Carcinoma to the Colon in the Setting of Benign Kidney Disease

Delayed Metastasis of Clear Cell Renal Carcinoma to the Colon in the Setting of Benign Kidney Disease

Metastatic renal cell carcinoma to pancreas and gastrointestinal tract: a clinicopathological study of 3 cases and review of literature

Metastatic renal clear cell carcinoma to the rectum, lungs, ilium, and lymph nodes

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