Solitary Brain Metastasis From Renal Cell Carcinoma 15 Years After Nephrectomy-Case Report-

Abstract

A 77-year-old man presented with a metastatic brain tumor 15 years after nephrectomy for a renal cell carcinoma. Neurological examination showed recent memory disturbance and slight right hemiparesis. Magnetic resonance imaging revealed a round well-demarcated mass extending from the left thalamus to the left trigone of the lateral ventricle. Preoperative angiography showed tumor staining. Surgery was performed by opening the inferior temporal sulcus. Only biopsy could be performed because of extensive bleeding from the tumor. Histological examination identified metastatic renal cell carcinoma. Gamma knife surgery was performed which resulted in resolution of his hemiparesis. Metastatic renal cell carcinoma should be considered even if nephrectomy was performed 10 or more years before presentation.

Simultaneous meningioma and brain metastasis from renal cell carcinoma – a rare presentation. Case report

“…Another hypothesis is that adjuvant therapy for renal cell carcinoma decreases host immunopotency and thus leads to faster development of brain lesions. 16 In the present report, the patient evaluated initially did not present central nervous system impairment: it was only after some years that it was found that he had brain metastasis.…”

“…1 The treatment may be difficult because central nervous system lesions are usually resistant to chemotherapy and radiotherapy. 15 Nonetheless, these lesions may respond to immunotherapy using alpha-interferon 16 or interleukin (IL)-2. After treatment of brain metastases, the median survival is about 4-5 months, 3 but aggressive surgical resection significantly increases this period.…”

“…There are some hypotheses explaining why brain metastasis may appear after a long period, in the absence of other metastatic lesions 16 in renal cell carcinoma cases. One hypothesis is that this might be because, in the initial stage, the brain metastasis is microscopic and does not cause any neurological symptoms.…”

Solitary metastasis of renal cell carcinoma to the third ventricle mimicking a colloid cyst: case report

“…The latter one is less frequently seen and most of them are benign lesions such as colloid cysts and choroid plexus papillomas. Although the choroid plexus is highly vascularized and theoretically is vulnerable to metastasis, a few cases have been reported (2,4,6,7,9). In those cases it is very rare for metastases to mimic a colloid cyst as in our case and to our knowledge only three cases have been previously reported.…”

“…Involvement of the ventricular system is not common and it is almost always associated with multiple brain metastases when it occurs (1,3,4). Solitary metastasis to the ventricular system and especially to the third ventricle is very rare (6,7,9). The most common solitary lesions of the third ventricle are colloid cyst and choroid plexus papilloma (5).…”