Solitary late recurrence of renal cell carcinoma presenting as duodenal ulcer

Freedman, Alan I.; Tomaszewski, John E.; Arsdalen, Keith N. Van

doi:10.1016/0090-4295(92)90248-u

Cited by 20 publications

(11 citation statements)

References 14 publications

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“…16 It has been reported that survival after late recurrence is improved with surgical treatment for patients with solitary metastasis when it is confined in one organ. [9][10][11] Surgical treatment, whenever delayed recurrence is resectable, represents the most appropriate therapeutic option. Indeed, McNicols et al reported that two of 18 patients who developed recurrence more than 10 years after Fig.…”

Section: Discussionmentioning

confidence: 99%

“…1 It has been reported that recurrence may occur many years after nephrectomy. [2][3][4][5][6][7][8][9][10][11] McNicols et al reported that 18 of 158 patients (11%) developed recurrence 10 years after nephrectomy. 2 Nakano et al reported that among 43 patients who received curative nephrectomy, two developed recurrence more than 10 years after the operation; an incidence of 4.7%.…”

Section: Introductionmentioning

confidence: 99%

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Recurrence of renal cell carcinoma more than 5 years after nephrectomy

Uchida¹,

Miyao²,

Masumori³

et al. 2002

Int J of Urology

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Objectives: We evaluated clinical features and predictive factors for the recurrence of renal cell carcinoma (RCC) developing more than 5 years after nephrectomy. Methods:We retrospectively reviewed 239 patients with RCC who underwent surgery for the primary lesion. To identify factors that affected recurrence more than 5 years after nephrectomy (delayed recurrence) and its clinical outcomes, we performed a multivariate analysis using Cox's proportional hazards model and a survival study.Results: Recurrence developing within 5 years after nephrectomy (early recurrence) was found in 57 patients and delayed recurrence in 11 patients. The multivariate analysis revealed no clinical and pathologic features influencing delayed recurrence in 114 patients who survived more than 5 years after nephrectomy without having early recurrence. The patients with delayed recurrence showed better clinical outcomes than those with early recurrence when the rate was determined from the time of recurrence. Conclusions: Although delayed recurrence is not a rare event for patients with RCC, no clinical and pathologic factors at the time of the initial treatment can predict the recurrence. Patients who are free of recurrence for more than 5 years after surgery for a primary lesion should be carefully followed up for delayed recurrence.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Recurrence of renal cell carcinoma more than 5 years after nephrectomy

Uchida¹,

Miyao²,

Masumori³

et al. 2002

Int J of Urology

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“…Irradiation with total doses of 30 -4 0 Gy and single doses of 2-3 Gy is also recommended for patients with more than one metastasis [11]. A similar procedure is also recommended for more than one metastasis [7], In our patient too. the originally solitary axillary metastasis was extirpated: he has now been living for 30 months with both, an axillary and a local recur rence.…”

Section: Discussionmentioning

confidence: 99%

“…Even métastasés to the heart, gall bladder. contralateral kidney and duodenum are not seldomly observed [6][7][8]. Much rarer are métastasés to the orbita.…”

Section: Discussionmentioning

confidence: 99%

“…Particularly local fail ures lead to considerable clinical problems with occasionally very strong pain, a situation, which can be satisfactorily m an aged by palliative irradiation [9]. It should be particularly emphasized that aggressive treatment of these generally older patients can markedly prolong their lives in the case of solitary métastasés [7], Thus, for example, surgical therapy achieved 5-year survival rates of 70% in 13 patients [3]. Already in 1978.…”

Section: Discussionmentioning

confidence: 99%

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Axillary Metastatic Spread in Connection with Local Recurrence of a Renal Cell Carcinoma 22 Years after the First Diagnosis – Case Report and Survey of the Literature

Wiegel

Degner

Comely³

et al. 1996

Oncol Res Treat

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Background: Manifold metastatic spread of renal cell carcinoma, even after long-term latency, is feared and unpredictable. Late recurrence after more than 10 years is not rare and then often initially misdiagnosed. Patient and Material: We are reporting on a 76-year-old male patient in whom an axillary lymph node metastasis was diagnosed 20 years after tumor nephrectomy and preoperative radiotherapy for a renal cell carcinoma. After tumor extirpation and 6 cycles of interferon therapy axillary failure recurred. Due to unexplained upper abdominal symptoms, an abdominal CT was carried out and a tentative diagnosis of a local recurrence in the former renal bed was made. Laparotomy was necessary due to a blocked passage resulting from a duodenal stenosis. Results: A local recurrence with compression of the duodenum was histologically confirmed. A duo-denojejunostomy was carried out for passage reconstruction. Conclusions: Regular follow-up care is particularly important for patients with renal cell carcinomas, since isolated late metastases can occur after 20 years or more. However, the diagnosis is often delayed, since a malignant disease originating from the primary is not expected after such a long interval. With aggressive therapy for those late recurrences/metastases, some patients can still survive for years depending on their general condition.

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