Renal clear cell carcinoma metastasis to the breast ten years after nephrectomy: a case report and literature review

Abstract

BackgroundRenal cell carcinoma most commonly metastasizes to the lungs, skeleton or liver. Metastatic renal cell carcinoma to the breast is very rare, especially for clear cell carcinoma, and few cases regarding this condition have been reported.Case PresentationThe case we presented was a 68-year-old Chinese female with metastatic renal clear cell carcinoma of the left breast 10 years after a nephrectomy. Identification of the metastatic renal clear cell carcinoma in the breast required multiple breast imaging modalities. Imaging showed a single, ovary-shaped, well-defined hypo-echoic mass, with abundant blood flow on ultrasound images. The mass was enhanced early on MRI, and it was hypointense on a T1-weighted image and hyperintense on a fat-saturated T2-weighted image. Following surgical excision of the tumor, a routine immunohistochemistry antibody panel on the tumor cells revealed negative staining for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (Her-2). Strong positive staining for the cluster of differentiation 10 (CD10) and vimentin was present.ConclusionThis case is unusual because of the site of metastatic progression. It is important for physicians to be aware of this progression so early diagnoses can be made, and appropriate therapeutic planning can be initiated.

Metastatic clear cell renal cell carcinoma presenting as breast lump: A rare case report

“…The metastatic lesions can present in a synchronous or metachronous manner. While some studies suggest no significant prognostic difference between metachronous and synchronous presentations, 15 others have shown worse prognosis in the synchronous group 16 . However, metastasis of CCRCC to breast is rare.…”

“…These features make it difficult to differentiate from benign breast tumors 18‐20 . The primary breast carcinomas are usually stiff and nonelastic, while the metastasis from renal cell carcinoma is softer 15 . The cases of metastasis of CCRCC are generally hypervascular 21 .…”

Renal Cell Carcinoma Diagnosis After Initial Detection on Screening Mammogram

“…The most common sites of metastasis are lung, bone, and liver; however, cases of late recurrence RCC have been diagnosed in unusual distant metastatic sites, including the skin, heart, and parotid glands [6]. The breast is a rare site for metastasis from any type of malignancy, and an initial diagnosis of RCC discovered within the breast is especially unusual [7][8][9].…”

Treatment of hepatic cystic echinococcosis patients with clear cell renal carcinoma: a case report

“…RCC is a malignant tumor that often metastasizes to lung, liver, bone and brain at early stage, and approximately 33% of RCC patients has metastatic masses, in which liver metastasis accounts for about 20% [ 17 ]. McKay et al reported that the presence of bone and liver metastases had a negative impact on survival [ 18 ].…”