Renal cell carcinoma metastasis to the ovary: a case report

Abstract

A 54-year-old woman referred to a specialist unit for weight loss, lethargy, and a palpable pelvic mass. Thought to have ovarian cancer metastasized to the kidney, underwent a left nephrectomy and para-aortic clearance, with a total abdominal hysterectomy and bilateral salpingo-oophorectomy with peritoneal biopsies. Histology proved it was actually a renal cell carcinoma metastasized to the ovaries. During further follow ups she had developed bone and pulmonary metastasis and died shortly after the diagnosis of metastasis. With only 14 reported cases in the literature increased awareness would aid management of similar cases.

Kidney Carcinoma Ovarian Metastasis: Review of the Literature

“…In one case, ovarian metastasis was detected eight years before the primary tumor [12]. Fuhrman grade was mentioned in 11 cases, including our case, four of them being grade 2, six grade 3, and a single case grade 4 with sarcomatoid features [7,24,29,30,33-34].…”

“…KC metastasis to the ovary is a rare event. This can be explained by its male predominance with the male-to-female ratio being 2:1 [7], low incidence of tumor emboli to the ovary, vascular sclerosis of the postmenopausal ovary when KC usually occurs, and the misdiagnoses of some metastatic tumors as primary ovarian neoplasms [8-9].…”

“…Regarding the presenting symptoms, 11 patients were asymptomatic with metastasis found on scheduled postoperative imaging. Seven patients presented with an abdominal mass [7,8,10,16,22,32], four with weight loss [7,11,13,34], three with vaginal bleeding [10,12,19], two with fever [14,20], two with irregular menses [18,21], two with an abdominal distension [11,26], two with ascites [8,15], abdominal pain [20,36], weight gain [15], fatigue [13], weakness [14], shortness of breath [8,36], pelvic pain [26], generalized malaise and decreased energy [30], flank pain [34], bone fracture [24], and thyroid metastasis [16]. In 26 patients, ovarian metastases were detected three months to 21 years after kidney involvement.…”

“…Subsequently, pazopanib was administered showing a poor response, followed by nivolumab until the patient succumbed to the disease. Radiotherapy was mentioned in four cases, two of them as palliative therapy for bone [7,29] and brain metastases [9] and in one case for parotid gland, thyroid, and brain metastases [18]. Follow-up was available in 28 patients with the longest period lasting 204 months.…”

Ovarian metastasis of clear cell renal cell carcinoma: A case report

“…7 The most frequent localizations of metastases are the lungs (50%-60%), lymph nodes (36%), bones (30%-40%), liver (30%-40%) and brain (5%). 6 However, metastases of this tumour (via hematogenous spread) have been identified in virtually every organ of the human body. 9 Among the reported clear cell RCC cases spreading to the female genital tract, most (about 80) metastasized to the ovarian metastasis of clear cell rcc vagina.…”