Nodular colonic lesion in a nephrectomized patient

Abstract

A 54 years old man casually diagnosed with right renal hypernephroma underwent a radical right nephrectomy seven years ago. The pathologic exam confirmed a clear cell carcinoma. In the follow up study, an abdominal CT demonstrated metastasis shaped lesions in liver and left kidney and a hypervascular colonic nodular lesion (Fig. 1). A colonoscopy was performed. The pathologic study of the colonic biopsies confirmed the presence of a clear cell carcinoma metastasis (immunohistochemistry was positive for cytokeratin AE1, AE3, vimentin, and focally CD10). Extension study was completed. Surgical treatment was not indicated and for an indefinite period of time sunitinib treatment was initiated. DISCUSSIONColonic metastasis of renal tumours is uncommon in medical literature. Descriptions deal with clear cell tumours (1), mixed granular and clear cells tumors (2) and sarcomatoid tumors (3). Differential diagnosis includes the also infrequent double kidney and colon cancer (4). Gastric and duodenum metastasis have also been described (5). Fig. 2. One cm diameter sized nodular lesion in ascending colon. Fig. 1. Image of hypervascularized 2.5 cm sized nodule dependant of ascending colon wall. Perinodular contrast enhancing and numerous small lymphadenopaties are also detected. The findings suggest colonic cancer. Nodular colonic lesion in a nephrectomized patient PICTURES IN DIGESTIVE PATHOLOGY