Sigmoid adenocarcinoma with metastases to the kidney: Report of a rare case and review of the literature

Abstract

Abstract. Distant metastases from colorectal cancer (CRC) most frequently spread to the liver and lungs. CRC metastasis to the kidney is extremely rare and may be generally associated with an unfavorable prognosis. Thus, patients with metastatic CRC and kidney metastasis are a diagnostic and therapeutic challenge. The present study reported the case of a 42-year-old male with a local recurrence of CRC following sigmoid resection with partial mesorectal excision, which had infiltrated the urinary bladder, requiring partial resection of the urinary bladder wall. After 4 years, the patient developed a recurrent tumor localized in the upper pole of the left kidney and underwent left nephrectomy. The patient remained disease-free 6 months after the surgery.

Isolated Renal and Ureter Metastasis as the First Manifestation of Rectal Adenocarcinoma

“…Up to date, only 20 cases have been reported worldwide. 2,[4][5][6] It usually occurs through hematogenous spread. They can spread through direct invasion with intra-ureteric growth 5,7 or local ureter mucosal metastasis without involving the muscular layer in rare cases.…”

Multifocal Urinary Tract Metastasis of Colorectal Carcinoma

“…Metastatic tumors can invade the ureter by direct extension and via vascular or lymphatic channels [2]. Regarding the former mechanism, cervical cancer is the most frequent reason, followed by CRC and other retroperitoneal tumors like lymphoma, liposarcoma, etc.…”

“…In contrast, the development of a true ureteral metastasis from distant primary tumors (such as the lung, breast, and prostate gland) is an unusual event, with approximately 400 cases reported [1]. Accordingly, CRC may invade the distant section of the ureter directly or via lymphatic channels and blood vessels [2], but hematogenous metastasis to the renal pelvis is a scarce event with rare case reports in the English literature [3]. Nevertheless, no data were found regarding the phenomenon of the concurrent renal pelvis and ureteral metastases in disseminated CRC.…”

Late recurrence of colorectal adenocarcinoma as a renal tumour by direct spread via the ureter

“…7,8 However, systemic chemotherapy is the treatment of choice for metastatic colorectal carcinoma and nephrectomy is not commonly used in the management of renal metastases from colorectal cancer. 6,8,9 The metastatic pathway in such cases is usually by haematogenous spread. Therefore, this case is quite remarkable and very rare as the spread occurred by direct intraureteric growth.…”

“…3 In the majority of cases, solitary renal metastases from colorectal carcinoma are asymptomatic and detected on surveillance imaging or as a result of increased CEA levels. 6 Survival appears to be longer in patients who are treated by surgery. Surgical intervention in carefully selected patients with oligometastatic disease and good performance status should therefore be considered.…”