scholarly journals Metachronous adrenal metastasis from operated contralateral renal cell carcinoma with adrenalectomy and iatrogenic Addison’s disease

2014 ◽  
Vol 8 (9-10) ◽  
pp. 744
Author(s):  
Hakan Öztürk ◽  
Serap Karaaslan

Metachronous adrenal metastasis from contralateral renal cell carcinoma (RCC) surgery is an extremely rare condition. Iatrogenic Addison’s disease occurring after metastasectomy (adrenalectomy) is an even rarer clinical entity. We present a case of a 68-year-old male with hematuria and left flank pain 9 years prior. The patient underwent left transperitoneal radical nephrectomy involving the ipsilateral adrenal glands due to a centrally-located, 75-mm in diameter solid mass lesion in the upper pole of the left kidney. The tumour lesion was confined within the renal capsule, and the histopathological examination revealed a Fuhrman nuclear grade II clear cell carcinoma. The patient underwent transperitoneal right adrenalectomy. The histopathological examination revealed metastasis of clear cell carcinoma. The patient was diagnosed with iatrogenic Addison’s disease based on the measurement of serum cortisol levels and the adrenocorticotropic hormone (ACTH) stimulation test, after which glucocorticoid and mineralocorticoid replacement was initiated. The patient did not have local recurrence or new metastasis in the first year of the follow-up. The decision to perform ipsilateral adrenalectomy during radical nephrectomy constitutes a challenge, and the operating surgeon must consider all these rare factors.

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Mohammad Saud Khan ◽  
Veena Balakrishnan Iyer ◽  
Neha Varshney

Renal cell carcinoma is known to cause metastasis to unusual sites, which can be both synchronous or metachronous. Thyroid gland is a rare site for metastasis, but when it occurs, renal cell carcinoma is the most common primary neoplasm. We report the case of a 81-year-old female patient who had a significant medical history of right clear cell renal carcinoma with adrenal metastasis. She underwent right radical nephrectomy and adrenalectomy followed by radiofrequency ablation of left adrenal metastasis and systemic chemotherapy with sunitinib. Eleven years later, she presented with dysphagia and was found to have distal esophageal adenocarcinoma. On imaging, there was incidental detection of a left renal mass lesion and a right thyroid nodule, which on histopathology and immunohistochemistry were confirmed to be clear cell carcinoma of renal origin.


2018 ◽  
Vol 199 (4S) ◽  
Author(s):  
Kristian Stensland ◽  
Jared Schober ◽  
David Canes ◽  
Navneet Ramesh ◽  
Brendan Waldoch ◽  
...  

2000 ◽  
Vol 124 (12) ◽  
pp. 1830-1832 ◽  
Author(s):  
Ronald J. Cohen ◽  
John E. McNeal ◽  
Marleen Susman ◽  
Loryn N. Sellner ◽  
Barry J. Iacopetta ◽  
...  

Abstract Sarcomatoid renal cell carcinoma (SRCC) is an aggressive tumor variant thought to arise predominantly from dedifferentiation of clear cell carcinoma. A few reports of SRCC associated with non–clear cell tumors led to the presumption that SRCC may arise from any renal cell carcinoma, although direct evidence of this is lacking. Cytogenetic studies on 3 previously documented SRCCs associated with papillary renal cancers showed either 3p deletions or absence of trisomy 7, 17 in the sarcomatoid tumors, suggesting origin from a coexistent clear cell tumor. The present case represents the first conclusive evidence of direct progression of non–clear cell carcinoma to SRCC with both tumor components containing multiple copies of chromosomes 7 and 17. Many genetic anomalies, including p53 mutations, frequently recognized in SRCC were not recognized in this case, highlighting the importance of cytogenetic evaluation of all SRCC. The patient is well and without evidence of tumor progression 1 year after surgery, and the sinister outlook of SRCC in association with clear cell carcinoma may not apply in SRCC of non–clear cell origin.


2018 ◽  
Vol 199 (4S) ◽  
Author(s):  
Kenji Tanabe ◽  
Kazutaka Saito ◽  
Kazuaki Nakagomi ◽  
Chizuru Arisawa ◽  
Tetsuro Tsukamoto ◽  
...  

2006 ◽  
Vol 175 (4S) ◽  
pp. 352-352
Author(s):  
James S. Magera ◽  
Bradley C. Leibovich ◽  
Christine M. Lohse ◽  
Shomik Sengupta ◽  
John C. Cheville ◽  
...  

2018 ◽  
Vol 10 (02) ◽  
pp. 241-244 ◽  
Author(s):  
Manjari Kishore ◽  
Devender Singh Chauhan ◽  
Shruti Dogra

AbstractCutaneous and intraoral metastasis from any malignancy is not common. Cutaneous spread is usually noted in 5%–10% of high-grade malignancies, as in carcinoma breast, lung, colon, ovary, and malignant melanoma. Only 4.6% cases of cutaneous spread are from renal cell carcinoma (RCC). Intraoral spread from RCC is much rarer with an incidence of approximately 1% of all malignant oral tumors, noted sometimes in tongue, palate, buccal mucosa, gingiva, and lips. RCC is a highly aggressive tumor which requires early diagnosis for increasing the chance of cure. In our case, a 54-year-old male presented with swelling over upper lip, scalp, and retromolar area, which on histopathology and immunohistochemistry revealed clear cell carcinoma compatible with metastatic RCC.


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