Metastatic renal cell carcinoma, with a radiographically occult primary tumor, presenting in the operative site of a thoracic meningioma: long-term follow-up

Heary, Robert F.; Agarwal, Nitin; Barrese, James C.; Barry, Maureen; Baisre, Ada

doi:10.3171/2014.6.spine13448

Cited by 15 publications

(10 citation statements)

References 26 publications

(32 reference statements)

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“…While the development of metastatic disease without an identifiable primary malignancy is extremely rare, there have been three well-documented cases of RCC presenting as metastatic disease without a renal primary, to our knowledge [5, 8, 9]. Johnson et al [9] reported a case of metastatic RCC to the adrenal gland, with an associated involuted region of the ipsilateral kidney which was proposed to represent spontaneous regression of the primary tumor.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis in both of these cases was supported by well-differentiated clear cell morphology and immunohistochemical staining. Heary et al [8] reported a case of metastatic RCC arising in an epidural meningioma resection site 3 years after initial surgery, with no radiographic evidence of an occult renal primary. Herein, we report a case of poorly differentiated renal cell carcinoma that presented as bilateral adrenal and liver metastases without evidence of a renal primary.…”

Section: Discussionmentioning

confidence: 99%

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Metastatic renal cell carcinoma without evidence of a renal primary

et al. 2015

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Purpose Metastatic renal cell carcinoma (RCC), without an identified kidney primary, has been reported rarely. We report a patient with RCC metastatic to bilateral adrenal glands and liver, without an apparent renal primary. We detail the immunohistochemical and molecular studies employed to substantiate the diagnosis of RCC and direct therapy. Methods Histopathologic findings were correlated with imaging data and supplemented by a panel of immunohistochemical stains, as well as tumor sequence analysis. Results Despite the presence of bilateral adrenal masses and lack of tumor within kidney parenchyma, the diagnosis of RCC was substantiated by immunohistochemistry (RCC+/PAX2+/PAX8+/Melan-A−/SF-1− among others) and molecular genetic analysis, harboring mutations in VHL, TP53, KDM5C, and PBRM1. After debulking surgery, based on the diagnosis of RCC and the molecular profile, the patient was treated with a tyrosine kinase inhibitor (sunitinib), resulting in stablilization of disease. Conclusions This case illustrates the role of mutational analysis in carcinomas with rare or unusual presentations, such as metastatic RCC without a renal primary.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Metastatic renal cell carcinoma without evidence of a renal primary

et al. 2015

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“…However, presenting with mRCC with an undetectable primary is infrequent. A total of 12 cases were documented based on our literature review [5][6][7][8][9][10][11][12]; none of which had diffuse lymphadenopathy metastasizing from an unidentifiable renal primary as presented in our case. In such a challenging situation, immunohistochemical profiling as well as the promising field of molecular genetics aid in reaching a diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Upon reviewing the literature, a total of 12 cases of metastatic kidney cancer had no evidence of a renal mass [5][6][7][8][9][10][11][12]. In this case report, a case of mRCC with an initial presentation of generalized lymphadenopathy with an undetectable primary will be presented.…”

Section: Introductionmentioning

confidence: 99%

Metastatic renal cell carcinoma with undetectable renal mass presenting as lymphadenopathy

2016

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Renal cell carcinoma has the ability to metastasize to any organ; about 16 % of affected patients present initially with metastasis. However, it is rare for this tumor to present with metastasis from an unidentified primary. The current use of immunohistochemistry and molecular genetics has enabled clinicians to reach a precise diagnosis. It has been hypothesized that the treatment protocol for metastatic renal cell carcinoma can be applied to cases with undetectable primary. In this paper, a novel case of metastatic renal cell carcinoma presenting with lymphadenopathy with no evidence of a primary renal lesion is reported from Kuwait cancer center.

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“…This entity has only rarely been described in the literature. [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Renal-cell carcinoma (RCC) is a group of cancers arising from the nephron, where 70% of RCC are clear-cell RCC. Because of mutation in the Von Hippel-Lindau gene, a high amount of vascular endothelial growth factor (VEGF) is produced, resulting in increased angiogenesis, cell growth, metabolism, and immunesuppression.…”

Section: Introductionmentioning

confidence: 99%

Carcinoma of Unknown Primary Site (CUP) With Metastatic Renal-Cell Carcinoma (mRCC) Histologic and Immunohistochemical Characteristics (CUP-mRCC): Results From Consecutive Patients Treated With Targeted Therapy and Review of Literature

Øverby

Duval

Ladekarl

et al. 2019

Clinical Genitourinary Cancer

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Diagnostic assessment occasionally presents carcinoma of unknown primary site (CUP) with metastatic renalcell carcinoma (mRCC) histologic and immunohistochemical characteristics (CUP-mRCC). We reviewed our single-institution experience and searched the PubMed database, and identified 10 patients treated at our institution; 60% were poor risk patients. Objective response rate was 40%, progression-free survival was 2.5 months, and overall survival was 5.7 months; and the literature search identified 42 CUP-mRCC cases, for a total of 52 cases of CUP-mRCC. Vascular endothelial growth factoretargeted therapy is valid, feasible, and safe in CUP-mRCC, and these patients should thus be identified among CUP patients for specific renal-cell carcinoma therapy. Background: Carcinoma of unknown primary site (CUP) is a heterogenous group of metastatic cancer with no detectable primary tumor site. Diagnostic assessment occasionally presents CUP with metastatic renal-cell carcinoma (mRCC) histologic and immunohistochemical characteristics (CUP-mRCC). Efficacy and toxicity data for vascular endothelial growth factor inhibitor therapies in CUP-mRCC patients are few. Patients and Methods: We retrospectively reviewed consecutive patients with CUP-mRCC at a single institution between 2007 and 2018. Treatment outcomes were assessed from initiation of renal-cell carcinomaespecific therapy, including response rate, progression-free survival, and overall survival. Results: Ten patients with CUP-mRCC were identified. Median age was 64 years. Histologies were clear-cell (30%), papillary type II (20%), and unclassified renal-cell (50%) carcinoma. International Metastatic Renal Cell Carcinoma Database Consortium risk group were favorable, intermediate, and poor in 0, 40%, and 60%, respectively. One patient received empiric first-line chemotherapy. Targeted treatments were pazopanib (n ¼ 7), sunitinib (n ¼ 2), and sorafenib (n ¼ 1). Objective response rate was 40%, progression-free survival was 2.5 months (95% confidence interval, 1.2-3.8), and overall survival was 5.7 months (95% confidence interval, 0-24.0). Stratified for International Metastatic Renal Cell Carcinoma Database Consortium risk, overall survival in intermediate versus poor risk group were 18.6 months and 2.3 months, respectively. Second-line therapy did not result in disease control. No new or unexpected toxicities were observed. Conclusion: CUP-mRCC treated with vascular endothelial growth factoretargeted therapy is valid, feasible, and safe even though these patients had several negative prognostic factors. CUP-mRCC patients should be identified among CUP patients for specific renal-cell carcinoma therapy.

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Metastatic renal cell carcinoma, with a radiographically occult primary tumor, presenting in the operative site of a thoracic meningioma: long-term follow-up

Cited by 15 publications

References 26 publications

Metastatic renal cell carcinoma without evidence of a renal primary

Metastatic renal cell carcinoma without evidence of a renal primary

Metastatic renal cell carcinoma with undetectable renal mass presenting as lymphadenopathy

Carcinoma of Unknown Primary Site (CUP) With Metastatic Renal-Cell Carcinoma (mRCC) Histologic and Immunohistochemical Characteristics (CUP-mRCC): Results From Consecutive Patients Treated With Targeted Therapy and Review of Literature

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