Solitary Metastasis from Renal Cell Carcinoma

Tolia, Bhupendra M.; Whitmore, Willet F.

doi:10.1016/s0022-5347(17)67155-6

Cited by 303 publications

(107 citation statements)

References 11 publications

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“…2 The nasal tip is a very unusual location of cutaneous metastases. The development of clown nose has been described in a few patients with chordoma, 5 kidney tumor, [6][7][8] hepatocellular carcinoma, 9 seminoma, 6 leukemia, 10 breast cancer, 6,11 cervix carcinoma, 12 and esophageal carcinoma. 13,14 Several cases has been described originated from lung carcinoma, including anaplastic large cell carcinoma and small cell carcinoma.…”

Section: Discussionmentioning

confidence: 99%

"Clown nose" as first manifestation of squamous cell carcinoma of the lung

Marcoval

Martínez-Molina

Bonfill-Ortí

et al. 2017

J Dermatol Case Rep

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Background: Skin metastases occur in 0.7% to 9% of all patients with cancer and are usually considered a late event in the evolution of most visceral carcinomas. The development of a nodular metastatic lesion on the nasal tip is known as clown nose sign. Main observation:We report a 64-year-old man that developed a nodular lesion on his nasal tip as first manifestation of squamous lung carcinoma. Conclusion:The biopsy of the cutaneous metastasis may be helpful to histopathologically confirm the suspected primary tumour avoiding invasive diagnostic proce-

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Section: Discussionmentioning

confidence: 99%

"Clown nose" as first manifestation of squamous cell carcinoma of the lung

Marcoval

Martínez-Molina

Bonfill-Ortí

et al. 2017

J Dermatol Case Rep

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“…Bundan dolayı metastatik lezyonun tamamen çıkarılması (total adrenalektomi) faydalıdır [8]. Metastatik lezyonun çı-karıldığı hastalarda 5 yıl ve üstü sağkalım %29-%35 olarak saptanmıştır [10]. Kemoterapi, radyoterapi ve hormon tedavisi gibi geniş bir spektrumu içeren tedaviler yaşam süresini uzatma açısından anlamlı bir başarı sağlamamıştır [10].…”

Section: Discussionunclassified

Radikal nefrektomi sonrası kontralateral soliter adrenal metastaz: Olgu sunumu

Tosun¹,

Topaktaş²,

Elbir³

et al. 2015

Dicle Med J

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ÖZETBöbreğin en sık görülen malign parankimal tümörü renal hücreli karsinomdur. Renal hücreli karsinom sıklıkla akciğer, karaciğer, lenf nodu ve kemiğe metastaz yapmaktadır fakat bu tümörün cerrahi sonrası karşı taraf soliter adrenal bez metastazı çok nadir saptanan bir durumdur. Tedavide sıklıkla metastaza yönelik agresif cerrahi primer yaklaşım olarak kabul görmektedir. Olgu sunumumuzda sol renal hücreli karsinom nedeniyle radikal cerrahi uygulanan 46 yaşındaki erkek hastanın dördüncü yıl kontrolünde saptananan karşı taraf soliter adrenal metastazı ve tedavisi literatür ışığında sunulmaktadır. Anahtar kelimeler: Adrenal, metastaz, nefrektomi ABSTRACTRenal cell carcinoma is the most common malignant parenchymal tumor of the kidney. Renal cell carcinoma is often metastasis to the lung, liver, lymph node and bone but after surgery opposite side of solitary adrenal metastasis of this tumor is very rare. Aggressive surgical approach is often preferred in treatment of metastasis. We presented in the literature a case of a 46-year-old man patient who underwent radical surgery due to left renal cell carcinoma with contralaterally solitary adrenal metastasis and management in the fourth year control. Key words: Adrenal, metastasis, nephrectomy GİRİŞErişkinlerde malign böbrek tümörlerinin %90 oranla en sık görüleni renal hücreli karsinomdur. Olguların tanı esnasında %30 unda uzak organ metastazı görülür [1]. Radikal nefrektomi renal hücreli karsinom tedavisinde altın standart yaklaşımdır. Bu radikal cerrahiye rağmen hastaların %20-%30' unda erken veya geç dönemde metastaz görülmektedir [2]. Renal hücreli kanser hemen hemen her organa metastaz yapmasına rağmen en sık metastaz alanları akciğer, lenf nodu, kemik, beyin ve karaciğerdir [2]. En kötü prognoz ile seyreden metastaz yeri kemik iken en iyi prognoz ile seyreden metastaz yeri akciğerdir. Renal hücreli karsinomların adrenal beze metastazı daha nadir görülmekle birlikte genellikle aynı taraf adrenal bez tutulur [3]. Karşı adrenal bez metastazları çok nadir görülür ve primer tümörle eş zamanlı veya cerrahi sonrası görülebilmektedir [4]. Olgu sunumumuzda lokalize böbrek tümörü tanısı ile sol radikal nefrektomi ve adrenalektomi yapılan ve ameliyat sonrası dördüncü yılda soliter karşı taraf (sağ) adrenal bezde renal hücreli karsinom metastazı saptanan 46 yaşında erkek hasta sunulmaktadır. OLGUKırk altı yaşında erkek hasta yaklaşık 3 aydır devam eden karın ağrısı şikâyeti ile 2010 yılında polikliniğimize başvurdu. Hastanın fizik muayene ve laboratuvar incelemeleri normal olarak gözlendi. Tüm batın ultrasonografi (USG) ve bilgisayarlı tomografi (BT) tetkiklerinde sol böbrek üst polde 7 cm çapında solid kitle tespit edildi. Diğer incelemelerde adrenal bezler ve diğer organlara ait metastaz ile uyumlu herhangi bir patolojik bulguya rastlanmadı. Şubat 2010 tarihinde klinik olarak lokalize böbrek tümörü tanısı alan hastaya sol torakolomber insizyonla sol radikal nefrektomi ve sol surrenalektomi yapıldı. Patolojik inceleme sonucu Fuhrman grade 2

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“…Other authors have reported survival rates of 30% or more at ®ve years following aggressive resection of solitary renal metastases. 33 Traditional thoracotomy has drawbacks, however, including increased operative time, incisional pain, and risks of great vessel injury and hemorrhage. Moreover, in order to visualize the anterior spinal column one lung must be collapsed, resulting in hypoventilation and stress that patients with underlying pulmonary disease or metastasis may not tolerate.…”

Section: Discussionmentioning

confidence: 99%

Spinal cord decompression: an endoscopically assisted approach for metastatic tumors

2001

Spinal Cord

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Study design: The paper describes a technique for complete vertebrectomy and spinal cord decompression, followed by a formal anterior column reconstruction, using endoscopic instruments. This procedure is indicated for patients with radioresistant metastasis of the thoracic spine, particularly those involving the upper thoracic segments where a thoracotomy is di cult and carries a high morbidity, and for patients with pulmonary disease who cannot tolerate a standard thoracotomy. Results in nine consecutive cases are reported. Objectives: To demonstrate the feasibility and bene®ts of endoscopically assisted decompression and stabilization through a single, extrapleural, posterolateral approach. Setting: The Cleveland Clinic, Cleveland, Ohio, USA. Methods: Posterolateral decompression of the thoracic spinal cord o ers potential advantages over traditional combined procedures (anterior thoracotomy and posterior instrumentation), including reduced operative time, decreased morbidity, and reduced hospital stay. Previous studies have not demonstrated the same neurological bene®t for posterolateral decompression as for anterior vertebrectomy and decompression, however, Surgical indications, rationale and technique for an improved posterolateral approach, augmented by endoscopic methods, are provided, and initial clinical results are described. Results: Drawbacks to the traditional posterolateral decompressions have included poor visualization of the spinal cord and anterior tumor, poor access to tumor on the side contralateral to the approach, and the need to manipulate the spinal cord to completely remove both adjacent tumor and tumor adherent to the dura. Transpedicular decompression using endoscopy is described in nine patients. The mean operative time for the combined procedure was 6.0 h, with a mean blood loss of 1677 cc. Neurological recovery and maintenance were excellent. Inpatient days averaged 6.5, and ICU days averaged 1.4. Two patients died of disease eight and 14 months post-op, and seven were living, with disease, 3 ± 36 months after surgery. Conclusions: Endoscopically assisted decompression can reduce morbidity, hospitalization, and treatment costs while matching the e cacy of traditional combined procedures. Endoscopy provides a readily available and easily applied tool that dramatically improves the surgeon's vision, providing light, magni®cation, and a direct view of remote structures. Spinal Cord (2001) 39, 482 ± 487

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Solitary Metastasis from Renal Cell Carcinoma

Cited by 303 publications

References 11 publications

"Clown nose" as first manifestation of squamous cell carcinoma of the lung

"Clown nose" as first manifestation of squamous cell carcinoma of the lung

Radikal nefrektomi sonrası kontralateral soliter adrenal metastaz: Olgu sunumu

Spinal cord decompression: an endoscopically assisted approach for metastatic tumors

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