Solitary parotid metastasis 8 years after a nephrectomy for renal cell carcinoma

Abstract

Renal cell carcinoma is a common cancer, known for its aggressive behavior and ability to metastasize nearly every organ system in the body. While the cancer commonly spreads to a select few organs and metastasis usually develops within 5 years of diagnosis, there have been numerous case reports of atypical sites of metastasis and cases of relapse up to decades after treatment. We present a case a 65-year-old male who presented with right preauricular swelling 8 years after the initial diagnosis and right nephrectomy for clear cell renal cell cancer. We take a look at previous case reports with similar presentations.

Parotid gland metastasis as an initial presentation of renal cell carcinoma: A case report

“…These factors together contribute to the unique hematogenous route of spread of renal cell carcinoma as a tumor thrombus into the lumen of the inferior vena cava ( 7 ). The other route of spread is the lymphatic system ( 3 ). The usual sites of metastases are the lung, liver, brain, and bone ( 6 ).…”

“…Nowadays, the first choice in the diagnosis of parotid swellings is ultrasonic examination ( 7 ). The diagnostic value of fine-needle aspiration biopsy (FNAB) is controversial, as it is associated with a high false-negative rate in the evaluation of metastatic renal cell carcinoma to the parotid gland; this is contributed its vascular nature ( 3 , 10 , 11 ). Pathological examination, immunohistochemical staining with antibodies against CD10, CEA, EMA, CK, and vimentin, are essential even if FNAB is diagnostic ( 3 , 7 , 9 , 12 ).…”

“…Imaging (CT/ MRI) can help in the assessment for possible extension or invasion. PET and CT scans are used in evaluating other sites of metastasis ( 3 ).…”

“…RCC is known for its aggressive behavior, where about one-third of patients present with metastatic disease ( 2 ). Metastasis usually occurs via hematogenous and lymphatic dissemination ( 3 ). Metastasis to the salivary glands is uncommon, accounting for 5% of all malignant tumors at that site.…”

Rare case of Clear Cell Renal Cell Carcinoma metastasizing to contralateral kidney and ipsilateral parotid more than five years following nephrectomy

“…The first cases of parotid involvement due to RCC metastases were reported by Patey et al in 1965 7 . Since then, there have been limited reported cases of this phenomenon 6,[8][9][10][11][12][13][14][15][16] . In their review of the literature, Lawlor et al reported 45 cases of RCC metastasizing to the parotid, of which only 31 were complete case presentations 6 .…”