Renal Cell Carcinoma Presenting as a Large Abdominal Mass with an Extensive Peritoneal Metastasis

Stavropoulos, N.J.; Deliveliotis, Ch.; Kouroupakis, D.; Demonakou, Maria; Kastriotis, J.; Dimopoulos, C.

doi:10.1159/000282715

Cited by 17 publications

(9 citation statements)

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“…first as presentation with disseminated peritoneal disease, second as recurrence after initial nephrectomy [ 20 ] and third, most common nowadays, as port site and omental mets after the laparoscopic excision of renal masses. Stavropoulos et al reported a case who presented with peritoneal metastasis and noted that the incidence of peritoneal metastasis in renal cell carcinoma is about 1% at autopsy [ 21 ]. The first port site metastasis was probably reported for the first time in 2006 by Dhobada et al [ 22 ], while recurrence in peritoneum was reported in 1990 [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Unusual progression of renal cell carcinoma with carcinomatosis peritoneii and Krukenberg tumour and alopecia with sunitinib therapy in young female

Pandey

Mahendran

Shukla³

2018

World J Surg Onc

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BackgroundSunitinib is a multiple receptor tyrosine kinase inhibitor (TKI) used for the treatment of renal cell carcinoma (RCC). It increases the median survival considerably with minimum side effects. Alopecia is one of the rare side effects. Metastasis to the ovary is also rare. We report a case of RCC metastasizing to the ovary developing alopecia early on starting sunitinib.Case presentationA 22-year-old hypothyroid girl underwent right radical nephrectomy for T2N0 RCC. Histopathology was clear cell carcinoma. Six months later, she presented with right iliac fossa pain, imaging revealed metastasis to the ileocolic junction and the ovary, an exploratory laparotomy was carried out and, after debulking, the patient was started on sunitinib. Four weeks after the start of the treatment, she developed alopecia. She was continued with sunitinib therapy till progression.ConclusionsThe present case shows a rare metastasis to the ovary and early onset of rare adverse event of alopecia on starting sunitinib therapy. In the presence of confounding factors like hypothyroidism and dandruff, establishing this as an adverse reaction of sunitinib is difficult. This case had a unique metastatic spread with involvement of the bowel, ovary and peritoneal carcinomatosis. Use of adjuvant TKI's after resection of primary tumour in nonmetastatic setting may reduce metastatic rates and increase progression-free survival.

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Section: Discussionmentioning

confidence: 99%

Unusual progression of renal cell carcinoma with carcinomatosis peritoneii and Krukenberg tumour and alopecia with sunitinib therapy in young female

Pandey

Mahendran

Shukla³

2018

World J Surg Onc

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“…In 1995, Stavropoulos et al proposed a possible mechanism leading to malignant ascites in renal cell cancer 12 , suggesting that growth of renal cancer outside the kidney’s capsule and Gerota’s fascia predisposes to local peritoneal involvement, starting a vicious cycle of ascites formation and more diffuse involvement of the peritoneum. They also described embolic hematogenous metastases involving the omentum, mesentery and peritoneum, initiating the process of development of malignant ascites.…”

Section: Discussionmentioning

confidence: 99%

Determinants and prognostic implications of malignant ascites in metastatic papillary renal cancer

Sidana

Kadakia

Friend

et al. 2017

Urologic Oncology: Seminars and Original Investigations

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Objective To describe the incidence of ascites in metastatic papillary renal cell cancer (pRCC), identify the factors associated with its development and evaluate its prognostic effect on the survival of these patients. Methods A retrospective evaluation of the medical records of patients with metastatic pRCC seen at National Cancer Institute (2000–2014) was undertaken. Logistic regression to identify predictors of the development of malignant ascites and Kaplan-Meier analysis to estimate survival was done. Results 106 consecutive patients with metastatic pRCC were identified; sufficient data was available in 100 patients to enable assessment of ascites. 20% had evidence of malignant ascites. Median age at diagnosis of ascites was 48.0 years (26.1–76.6 years) and median time to development of ascites from initial diagnosis of metastatic disease was 16.0 (0–73.3) months. There was no significant difference in the incidence of ascites between patients with hereditary or sporadic pRCC (p=0.803) or among patients with different subtypes of pRCC (p=0.456). Elevated platelet-lymphocyte ratio (PLR) predicted development of malignant ascites in our cohort (p=0.009). Median overall survival was shorter for patients who developed ascites [25.0(10.2–39.8 months] compared to patients who did not develop this complication [42.5(30.5–54.4) months, p=0.041]. Conclusion To our knowledge, this is the first systematic evaluation of the incidence, predictors and prognostic impact of ascites in metastatic pRCC. Malignant ascites is a common manifestation of metastatic pRCC and is associated with a shorter overall survival. An elevated PLR predicts a higher risk of developing malignant ascites.

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“…Some aggressive RCC subtypes with adverse histopathological features (sarcomatoid differentiation etc.) can present with diffuse peritoneal metastases involving the omentum [7] , [8] . However, development of metachronous omental metastasis(es), particulary in the absence of diffuse peritoneal involvement, is an extremely rare condition in the natural history of RCC.…”

Section: Discussionmentioning

confidence: 99%

Isolated omental metastasis of renal cell carcinoma after extraperitoneal open partial nephrectomy: A case report

Acar

Mut

Sağlıcan

et al. 2016

International Journal of Surgery Case Reports

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Renal Cell Carcinoma Presenting as a Large Abdominal Mass with an Extensive Peritoneal Metastasis

Abstract: We report a case of renal cell carcinoma with an extensive intraperitoneal metastasis at the time of diagnosis. This type of metastasis is very rare for renal cell carcinoma and is identified in only 1 % of the metastases at autopsy. The findings of computed tomography are presented.

Cited by 17 publications

References 1 publication

Unusual progression of renal cell carcinoma with carcinomatosis peritoneii and Krukenberg tumour and alopecia with sunitinib therapy in young female

Unusual progression of renal cell carcinoma with carcinomatosis peritoneii and Krukenberg tumour and alopecia with sunitinib therapy in young female

Determinants and prognostic implications of malignant ascites in metastatic papillary renal cancer

Isolated omental metastasis of renal cell carcinoma after extraperitoneal open partial nephrectomy: A case report

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