Metastatic renal cell cancer

Wee, Low Kok; Shyu, Rong-Yaun; Sheu, Lai-Fa; Hsieh, Tsai‐Yuan; Yan, Juh-Cheng; Chen, Peng‐Jen

doi:10.1016/s0016-5107(04)01542-1

Cited by 17 publications

(6 citation statements)

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“…The reported incidence varies from 1.6% to 11% in autopsy studies and 2% to 5% in clinical studies [18,19]. This metastasis typically manifests in a metachronous fashion and, in numerous cases, often occurs several years after primary tumor treatment [20,21]. Due to the rarity of this kind of metastatic pattern, clinical studies concerning the treatment of CCRCC metastasis in the pancreas are currently lacking.…”

Section: Discussionmentioning

confidence: 99%

The Pancreas as a Target of Metastasis from Renal Cell Carcinoma: Is Surgery Feasible and Safe? A Single-Center Experience in a High-Volume and Certified Pancreatic Surgery Center in Germany

Al-Madhi,

Acciuffi,

Meyer

et al. 2024

JCM

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Background: Secondary malignant tumors of the pancreas are rare, representing 2–5% of all pancreatic malignancies. Nevertheless, the pancreas is one of the target organs in cases of metastatic clear cell renal cell carcinoma (CCRCC). Additionally, recurrent metastasis may occur. Surgical resection remains the best and prognostically most favorable therapeutic option in cases of solitary pancreatic metastasis. Aim: To review retrospectively the clinical tumor registry of the University Hospital of Magdeburg, Germany, for this rare entity, performing a clinical systematic single-center observational study (design). Methods: A retrospective cohort analysis of consecutive patients who had undergone pancreatic resection for metastatic CCRC was performed in a single high-volume certified center for pancreatic surgery in Germany from 2010 to 2022. Results: All patients (n = 17) included in this study had a metachronous metastasis from a CCRCC. Surgery was performed at a median time interval of 12 (range, 9–16) years after primary resection for CCRCC. All 17 patients were asymptomatic at the time of diagnosis. Three of those patients (17.6%) presented with recurrent metastasis in a different part of the pancreas during follow-up. In a total of 17 patients, including those with recurrent disease, a surgical resection was performed; Pancreatoduodenectomy was performed in 6 patients (35%); left pancreatectomy with splenectomy was performed in 7 patients (41%). The rest of the patients underwent either a spleen-preserving pancreatic tail resection, local resection of the tumor lesion or a total pancreatectomy. The postoperative mortality rate was 6%. Concerning histopathological findings, seven patients (41%) had multifocal metastasis. An R0 resection could be achieved in all cases. The overall survival at one, three and five years was 85%, 85% and 72%, respectively, during a median follow-up of 43 months. Conclusions: CCRC pancreatic metastases can occur many years after the initial treatment of the primary tumor. Surgery for such a malignancy seems feasible and safe; it offers very good short- and long-term outcomes, as indicated. A repeated pancreatic resection can also be safely performed.

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Section: Discussionmentioning

confidence: 99%

The Pancreas as a Target of Metastasis from Renal Cell Carcinoma: Is Surgery Feasible and Safe? A Single-Center Experience in a High-Volume and Certified Pancreatic Surgery Center in Germany

Al-Madhi,

Acciuffi,

Meyer

et al. 2024

JCM

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“…However, unusual sites of metastases are characteristic of RCC, and virtually, any organ site can be involved, including the thyroid, pancreas, skeletal muscles, and skin [3,6]. Gastric metastatic tumor from RCC is exceedingly rare and the literature is limited to a few case reports [2][3][4][6][7][8][9][10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

“…Blake et al [15] employed angiographic embolization whereas Lamb et al [16] utilized octerotide when they were unsuccessful to control the GI bleeding with angiographic embolization. Kok et al [13] used epinephrine to successfully control active bleeding that resulted from biopsies taken from the metastatic lesion. As there was no evidence of active bleeding in our patient, we did not resort to endoscopic or any other therapy.…”

Section: Discussionmentioning

confidence: 99%

Upper Gastrointestinal Bleeding Revealing the Stomach Metastases of Renal Cell Carcinoma

Kibria

Sharma

Rao

2009

J Gastrointest Canc

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Introduction Renal cell carcinoma (RCC) constitutes 3% of all adult malignancies and often presents insidiously. Consequently, 25-30% of patients have metastases at the time of diagnosis. Discussion Gastrointestinal (GI) bleeding from RCC metastases is an uncommon and underrecognized manifestation of this disease. We hereby report a rare case of RCC with stomach metastasis which heralded the primary manifestation of the disease. This case highlights the importance of maintaining vigilance for unusual causes during endoscopy in cases of upper GI hemorrhage.Keywords renal cell carcinoma . upper gastrointestinal bleeding . stomach metastasis . initial presentation Case ReportA 53-year-old male presented to the emergency room with 1 week history of melena, generalized fatigue, and dizziness. Other significant medical problems included coronary artery disease, type 2 diabetes, hypertension, dyslipidemia, and chronic obstructive pulmonary disease. He was an ex-smoker with a 40-pack yearcigarette smoking history. Medications included aspirin, metoprolol, simvastatin, and metformin. He denied recent use of over-the-counter or nonsteroidal antiinflammatory medications. Physical examination revealed a cachectic pale gentleman who was in moderate distress. Blood pressure was 70/50 mm Hg and heart rate was 130 beats/min. Heart and lungs were normal. Abdominal examination revealed mild epigastric tenderness to deep palpation. There was no rebound tenderness or guarding or palpable masses. Laboratory tests revealed hemoglobin of 6.3 g/dl (13.8-17.2 g/dl) with microcytic picture, hematocrit of 19.5% (41-50%), blood urea nitrogen of 74 mg/dl (3-29 mg/dl), creatinine of 3.0 mg/dl (0.5-1.4 mg/dl), and calcium of 14.6 mg/dl (8.5-10.4 mg/dl). Urinalysis did not reveal any red blood cells. White blood count, platelets, and coagulation studies were all normal. After initial resuscitation, an emergent esophagogastroduodenoscopy was performed. A 1.5-cm vascular polypoid mass was noted in the fundus of the stomach (Fig. 1a, b), which was biopsied. No other lesions were noted in the esophagus and the duodenum. Histology from the stomach mass revealed small, vacuolated, clear cells highlighted by immunostaining with AE 1/3, CA 9, and CD 10 and showed strong reactivity with Vimentin ( Fig. 2a-c). These findings confirmed the diagnosis of clear cell subtype metastatic renal cell carcinoma (RCC). Subsequent computed tomography (CT) of the abdomen revealed a 5×7.4-cm ill-defined mass in the inferior pole of the right kidney, multiple pulmonary nodules, and osteolytic lesions involving multiple vertebrae and sternum suggestive of primary renal cancer with metastatic disease (Fig. 3a, b). Because of the extensive metastatic disease, palliative therapy options were discussed with the patient but he declined any further interventions and opted for

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“…We identified 73 cases of RCC with gastric metastasis from literature reviews. Including the patient treated in our hospital, there were 5 cases of RCC with simultaneous solitary gastric metastasis [4,[16][17][18][19] (Table 1), 4 cases with gastric and multiple-site metastases [20][21][22][23] (Table 2), 21 cases with solitary metachronous gastric metastasis [16,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] (Table 3), and 44 cases with metachronous gastric and multiple-site metastases [32, (Table 4).…”

Section: Literature Reviewmentioning

confidence: 99%

Application of 18F Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Monitoring Gastric Metastasis and Cancer Thrombi from Renal Cell Carcinoma

Xiong

Zhang

Zhou

et al. 2022

Journal of Oncology

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Background. Renal cell carcinoma (RCC) with gastric metastasis is rare, particularly accompanied by multiple cancer thrombi. Methods. We reported a 66-year-old man with a history of a right radical nephrectomy because of RCC. The patient underwent 18F prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) scanning after 6 months of targeted therapy because of gastric metastasis and cancer thrombi. We conducted a systematic review of the literature and identified 73 cases of RCC with gastric metastasis. We analyzed the clinicopathological characteristics, therapies, and outcomes of patients. Results. 18F-PSMA PET/CT showed a large mass in the gastric fundus and cancer thrombi in the right atrium, inferior vena cava, and splenic vein with intense tracer uptake. Other metastases with increased tracer uptake included multiple bones and abdominal lymph nodes. The majority of gastric metastasis of RCC were men (53/73, 72.6%), with a median age at presentation of 67 (from 48 to 87) years. Gastric metastasis of RCC was mainly metachronous, and presented with small polyps or mass appearance and often accompanied by multiple-site metastases and gastrointestinal symptoms. An overall median interval between nephrectomy and diagnosis of gastric metastasis was 6 (from 0.1 to 23) years, and an overall median survival time was 14 (from 0.25 to 72) months. The median interval time of solitary gastric metastasis was longer than gastric metastasis with multiple-site metastases (7 vs.5 years; P = 0.034 ). Patients with gastric and multiple-site metastases had higher mortality than patients with solitary metastasis (17 vs.1; P = 0.028 ). The patients with synchronous gastric metastasis had a shorter survival time than metachronous gastric metastasis (6 vs.17 months; P = 0.018 ). Conclusions. Postoperative follow-up of multiple imaging modalities to monitor recurrence and metastasis is necessary and important. PSMA PET/CT can improve the detection sensitivity of RCC, especially in metastatic clear cell renal cell carcinoma (ccRCC), and could provide a basis for disease staging, restaging, and therapeutic efficacy evaluation.

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Metastatic renal cell cancer

Cited by 17 publications

References 0 publications

The Pancreas as a Target of Metastasis from Renal Cell Carcinoma: Is Surgery Feasible and Safe? A Single-Center Experience in a High-Volume and Certified Pancreatic Surgery Center in Germany

The Pancreas as a Target of Metastasis from Renal Cell Carcinoma: Is Surgery Feasible and Safe? A Single-Center Experience in a High-Volume and Certified Pancreatic Surgery Center in Germany

Upper Gastrointestinal Bleeding Revealing the Stomach Metastases of Renal Cell Carcinoma

Application of 18F Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Monitoring Gastric Metastasis and Cancer Thrombi from Renal Cell Carcinoma

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