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Sun J, Zhang Z, Xiao Y, Li H, Ji Z, Lian P, Zhang X. Skeletal Muscle Metastasis From Renal Cell Carcinoma: A Case Series and Literature Review. Front Surg 2022; 9:762540. [PMID: 35310441 PMCID: PMC8927030 DOI: 10.3389/fsurg.2022.762540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 01/28/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesSkeletal muscle metastasis (SMM) from renal cell carcinoma (RCC) has been rarely reported. This case series was performed to increase the clinicians' understanding of its clinical features and treatments.MethodsWe evaluated the clinical presentations, diagnoses, and treatments of 2 patients with SMM from RCC in our hospital and 39 cases reported in the literature.ResultsAmong the 41 patients, 4 (9.76%) were women and 37 (90.24%) were all men. The average age was 60.5 ± 12.6 years old (range from 7 to 81). The size of tumors varied from 1 to 28 cm, and the metastatic sites of 6 (14.63%) cases were in the heads, 20 (48.78%) in the limbs, 9 (21.95%) in the trunks, 3 (7.32%) in the buttock, and the other 3 (7.32%) were multiple sites. The mean of intervals between the RCC and the discovery of the first SMM was 73.61 months. More than half of the patients (25, 60.98%) were diagnosed by MRI and 25 (60.98%) patients performed a biopsy of the mass to establish the diagnosis. Finally, 30 (73.17%) cases performed mass excision. Then the adjuvant therapy was performed in 18 patients including immunotherapy, radiotherapy, chemotherapy, and targeted therapy. The median follow-up after SMM was 9 months (P25, P75: 5, 23), in which the longest survival time of patients with SMM of RCC was 8 years while the shortest was only 3 months.ConclusionThe characteristic clinical feature of SMM from RCC is asymptomatic masses or swelling with a long history which can be preoperative suspiciously diagnosed by MRI. The rapid biopsy of suspected lesions, determination of other metastasis sites, resection of metastasis, and systematic treatment are the recommended treatments of it.
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Affiliation(s)
- Juan Sun
- Division of General Surgery, Department of Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Zimu Zhang
- Division of General Surgery, Department of Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yu Xiao
- Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Hanzhong Li
- Division of Urology, Department of Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Zhigang Ji
- Division of Urology, Department of Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Penghu Lian
- Division of Urology, Department of Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
- *Correspondence: Penghu Lian
| | - Xuebin Zhang
- Division of Urology, Department of Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
- Xuebin Zhang
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Lasagna A, Ghiara M, A Mahagna A, A Lombardini A, Cuzzocrea F, Porta C. Skeletal muscle metastases: pitfalls and challenges of a highly inhospitable environment. Future Oncol 2022; 18:897-901. [PMID: 35094526 DOI: 10.2217/fon-2021-1489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Angioletta Lasagna
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Piazzale C. Golgi 19, Pavia 27100, Italy
| | - Matteo Ghiara
- Orthopedics Unit, Fondazione IRCCS Policlinico San Matteo, Piazzale C. Golgi 19, Pavia 27100, Italy
| | - Antonio A Mahagna
- Orthopedics Unit, Fondazione IRCCS Policlinico San Matteo, Piazzale C. Golgi 19, Pavia 27100, Italy
| | - Ambrogio A Lombardini
- Orthopedics Unit, Fondazione IRCCS Policlinico San Matteo, Piazzale C. Golgi 19, Pavia 27100, Italy
| | - Fabrizio Cuzzocrea
- Orthopedics Unit, Fondazione IRCCS Policlinico San Matteo, Piazzale C. Golgi 19, Pavia 27100, Italy
| | - Camillo Porta
- Chair of Oncology, Department of Biomedical Sciences & Human Oncology, University of Bari 'A. Moro' & A.O.U. Consorziale Policlinico di Bari, Bari 70124, Italy
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Caunter G, Faeez Md Noh MS, Safri LS, Kumar K, Md Idris MA, Harunarashid H, Yahaya A. Delayed Presentation of Metastatic Renal Cell Carcinoma as an Arteriovenous Malformation Mimicking Vascular Tumour of the Forearm. EJVES Short Rep 2019; 44:19-22. [PMID: 31453386 PMCID: PMC6704251 DOI: 10.1016/j.ejvssr.2019.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/13/2019] [Accepted: 06/19/2019] [Indexed: 10/26/2022] Open
Abstract
Introduction The development of metastatic renal cell carcinoma (RCC) many years after a nephrectomy is not common but has been reported. A metastasis appearing as a hypervascular tumour, mimicking an arteriovenous malformation (AVM), is a highly unusual phenomenon, with a biopsy required for diagnostic confirmation. Surgery is an option for a solitary metastatic lesion amenable to complete excision, with proven survival benefits. However, widespread metastatic disease carries a very poor prognosis, and is best treated with systemic agents such as anti-angiogenic drugs or tyrosine kinase inhibitors. Report A 58 year old man developed an AVM mimicking a vascular tumour within his left brachioradialis muscle 10 years after a nephrectomy for RCC. Ultrasound and magnetic resonance imaging did not reveal any suspicious features of the vascular lesion.The lesion was successfully removed surgically, and was later proven histopathologically to be metastatic RCC. Further imaging showed widespread metastatic disease, and the patient survived only 15 months after receiving tyrosine kinase inhibitor therapy. Discussion This case report aims to highlight a few important points: RCC metastases may be hypervascular, mimicking an AVM. A long disease free interval does not necessarily exclude recurrence or metastasis, as in this case, therefore long term surveillance is recommended. A high index of suspicion must be maintained to avoid delay in treatment, and biopsy of any suspicious lesion for histological examination is mandatory, albeit after many years of cancer remission. Whole body imaging with computed tomography or positron emission tomography computed tomography may detect clinically occult recurrence or metastases, and is important to guide further treatment.
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Affiliation(s)
- Gillian Caunter
- Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | | | - Lenny Suryani Safri
- Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Krishna Kumar
- Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Mohamad Azim Md Idris
- Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Hanafiah Harunarashid
- Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Azyani Yahaya
- Department of Pathology, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
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Angelini A, Eldesouqi A, Belluzzi E, Cappellesso R, Ruggieri P. Metastatic Lesion From Clear-cell Renal Carcinoma After 40 Years and a Review of the Literature. Clin Genitourin Cancer 2018; 17:e372-e376. [PMID: 30587402 DOI: 10.1016/j.clgc.2018.11.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 11/26/2018] [Indexed: 11/16/2022]
Affiliation(s)
- Andrea Angelini
- Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy.
| | - Ahmed Eldesouqi
- Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy; Department of Orthopedics and Traumatology, University of Alexandria, Alexandria, Egypt
| | - Elisa Belluzzi
- Musculoskeletal Pathology and Oncology Laboratory, Department of Orthopaedics and Orthopaedic Oncology, University of Padova, Padova, Italy
| | - Rocco Cappellesso
- Surgical Pathology and Cytopathology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy
| | - Pietro Ruggieri
- Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy
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Pretell-Mazzini J, de Neyra JZS, Luengo-Alonso G, Shemesh S. Skeletal muscle metastasis from the most common carcinomas orthopedic surgeons deal with. A systematic review of the literature. Arch Orthop Trauma Surg 2017; 137:1477-1489. [PMID: 28852837 DOI: 10.1007/s00402-017-2782-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Indexed: 12/19/2022]
Abstract
INTRODUCTION There is scarce information in the literature dealing with the clinical presentation, management and oncologic outcomes of skeletal muscle metastases (SMM). We sought to perform a systematic review of the literature to investigate: (1) tumor characteristics of SMM, (2) therapeutic approach, and (3) oncological outcomes. METHODS A systematic review of the literature was performed using PubMed and EMBASE search engines. A total of 3231 references were reviewed and 49 studies were included. Demographic data, presentation characteristics, and oncological outcomes were recorded. Statistical analysis was performed using SPSS 22.0 software (IBM; Armonk, New York) and Comprehensive Meta-Analysis software version 3 (Biostat, Inc.), with p < 0.05 as statistically significant. RESULTS A total of 231 patients were included. These tumors presented more commonly on males 58.4% (135/231), with a mean age of 60.08 ± 10.6 years, and in the axial area 39.6% (88/222). The most common carcinoma type was lung 41.1% (95/231). Resection of a single metastases did not change survival significantly (p = 0.992). LRR was higher within the group of patients that underwent WLE compared with non-WLE [31.3% (23/74) vs. 8.7% (2/23), p ≤ 0.001]. Kaplan-Meier survival analysis for the entire cohort showed an estimate of 15.3 months [95% confidence interval (CI) 11.6-19; standard error (SE) 0.432], with lung carcinoma carrying the worst prognosis 6.7 months (95% CI 5.4-8.07; SE 0.68). Patients with a single SMM showed a worse estimate mean survival time compared to patients with multiple metastases limited to muscles [8.6 months (95% CI 4.7-12.5; SE 2.0) vs 25.4 months (95% CI 19.8-31.05; SE 2.8; p ≤ 0.001)]. CONCLUSIONS Overall survival is poor and is driven mainly by the type of carcinoma. An Increased LRR might be present due to the systemic nature of the condition, and degree of control of the primary carcinoma.
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Affiliation(s)
- Juan Pretell-Mazzini
- Division of Musculoskeletal Oncology, Department of Orthopedics, Miller School of Medicine, University of Miami, 1400 NW 12th Avenue East Building, 4th Floor Suite 4036, Miami, FL, 33136, USA.
| | - Jaime Zorrilla S de Neyra
- PGY-4 Orthopedic Surgery, Department of Orthopaedic Surgery, 12 Octubre University Hospital, Madrid, Spain
| | - Gonzalo Luengo-Alonso
- PGY-3 Orthopedic Surgery, Department of Orthopaedic Surgery, 12 Octubre University Hospital, Madrid, Spain
| | - Shai Shemesh
- Division of Musculoskeletal Oncology, Department of Orthopedics, University of Miami, Miami, USA
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Kozak O, Turzyński P, Markiet K, Pieńkowska J, Skrobisz-Balandowska K, Studniarek M. Uncharacteristic metastasis of a renal clear-cell carcinoma to the muscles of the forearm-case report. BJR Case Rep 2017; 3:20150495. [PMID: 30363241 PMCID: PMC6159187 DOI: 10.1259/bjrcr.20150495] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 12/20/2016] [Accepted: 01/13/2017] [Indexed: 12/18/2022] Open
Abstract
Clear-cell renal carcinoma constitutes over 90% of all cases of renal cancers. One of the least common locations of metastases of this type of cancer are skeletal muscles. We believe that this is the first case ever presented of renal clear-cell cancer metastasis to the extensor digitorum muscle. Our case should sensitize clinicians and radiologists dealing with this type of carcinoma to the abundance of metastases, their uncommon locations and frequently asymptomatic nature, which all makes them easy to overlook on physical and imaging examinations.
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Affiliation(s)
- Oliwia Kozak
- Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| | - Paweł Turzyński
- Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| | - Karolina Markiet
- 2nd Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| | - Joanna Pieńkowska
- 2nd Department of Radiology, Medical University of Gdansk, Gdansk, Poland
| | | | - Michał Studniarek
- Department of Radiology, Medical University of Gdansk, Gdansk, Poland
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Haygood TM, Sayyouh M, Wong J, Lin JC, Matamoros A, Sandler C, Madewell JE. Skeletal Muscle Metastasis from Renal Cell Carcinoma: 21 cases and review of the literature. Sultan Qaboos Univ Med J 2015; 15:e327-37. [PMID: 26357552 DOI: 10.18295/squmj.2015.15.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 03/10/2015] [Accepted: 03/30/2015] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES This study aimed to raise radiologists' awareness of skeletal muscle metastases (SMM) in renal cell carcinoma (RCC) cases and to clarify their imaging appearance. METHODS A retrospective analysis was undertaken of 21 patients between 44-75 years old with 72 SMM treated from January 1990 to May 2009 at the MD Anderson Cancer Center in Houston, Texas, USA. Additionally, 37 patients with 44 SMM from a literature review were analysed. RESULTS Among the 21 patients, the majority of SMM were asymptomatic and detected via computed tomography (CT). Mean metastasis size was 18.3 mm and the most common site was the trunk muscles (83.3%). The interval between discovery of the primary tumour and metastasis detection ranged up to 234 months. Peripheral enhancement (47.1%) was the most common post-contrast CT pattern and non-contrasted CT lesions were often isodense. Magnetic resonance imaging (MRI) characteristics were varied. Five lesions with available T1-weighted pre-contrast images were hyperintense to the surrounding muscle. Other organ metastases were present in 20 patients. Of the 44 SMM reported in the literature, the majority were symptomatic. Average metastasis size was 53.4 mm and only 20.5% of SMM were in trunk muscles. The average interval between tumour discovery and metastasis detection was 101 months. Other organ metastases were recorded in 17 out of 29 patients. CONCLUSION SMM should always be considered in patients with RCC, even well after primary treatment. SMM from RCC may be invisible on CT without intravenous contrast; contrast-enhanced studies are therefore recommended. SMM are often hyperintense to the surrounding muscle on T1-weighted MRI scans.
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Affiliation(s)
- Tamara Miner Haygood
- Department of Diagnostic Radiology, MD Anderson Cancer Center, Houston, Texas, USA
| | - Mohamed Sayyouh
- Department of Diagnostic Radiology, University of Michigan Health System, University of Michigan, Ann Arbor, USA
| | - Jason Wong
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada; ; School of Population & Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Aurelio Matamoros
- Department of Diagnostic Radiology, MD Anderson Cancer Center, Houston, Texas, USA
| | - Carl Sandler
- Department of Diagnostic Radiology, MD Anderson Cancer Center, Houston, Texas, USA
| | - John E Madewell
- Department of Diagnostic Radiology, MD Anderson Cancer Center, Houston, Texas, USA
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8
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Abstract
BACKGROUND Skeletal muscle metastases (SMM) are very rare because of complex resistance of the musculature to metastatic invasion. Previously, positron emission tomography (PET) imaging of SMM has been reported only in few reports. A systematic analysis of SMM features in PET/CT has not been performed before. PURPOSE To study PET/CT findings of SMM in a larger group of patients with known malignancies and to determine PET/CT patterns of SMM in different primary tumors. MATERIAL AND METHODS Between January 2009 and December 2011 581 patients with lung cancer were investigated by PET with 18 F-fluordeoxyglucose (FDG PET) and computed tomography (CT) at the Center of Fusion Imaging, Halle. In five patients SMM were identified. Furthermore, PubMed database was screened for muscle metastases. Only articles containing SUV of SMM were considered in the study. Twenty-one articles with 33 patients could be included in this meta-analysis from the literature. RESULTS At our center the prevalence of SMM was 0.9%. Our analysis comprised 38 patients with 67 muscle metastases. All identified SMM presented as intramuscular focal abnormal activity with SUV ranging from 2.4 to 25.9, median SUV 7.8. The median size of the muscle metastases was 2.5 cm (range, 0.6-6.5 cm). There were no significant differences between SUV and size of SMM arising from lung cancer, renal cell carcinoma, and esophageal cancer. Also, there was no correlation between SUV and size of SMM (r = 0.101, P = 0.558) and between SUV of SMM and primary tumors (r = 0.138, P = 0.686). In nine (23.7%) of the 38 patients, the identified SMM were isolated distant metastases or isolated tumor recurrence. CONCLUSION SMM manifested on PET/CT as focal hypermetabolic intramuscular areas with different SUV. There were no significant differences between SUV or size of the identified SMM in esophageal cancer, renal cell carcinoma, and lung cancer.
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Affiliation(s)
- Alexey Surov
- Department of Radiology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | | | - Andreas Wienke
- Department of Epidemiology, Biometry and Informatics Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Dominik Schramm
- Department of Radiology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
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Lohiya V, Lohiya S, Windsor K. A large thigh mass: a blood clot or a rare skeletal muscle metastasis from renal cell carcinoma. SPRINGERPLUS 2013; 2:399. [PMID: 24024088 PMCID: PMC3765606 DOI: 10.1186/2193-1801-2-399] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 08/13/2013] [Indexed: 11/24/2022]
Abstract
Background Renal cell carcinoma (RCC) is a tumor known for its unusual presentations and high rate of metastasis. Metastasis to lung, liver, bone and brain are common, but to skeletal muscle(SM) is very rare. Because only 11% of the RCC metastases to SM present after 10 years of initial presentation, there is no general consensus for its annual surveillance. Methods We report a case of a 58 year old male with a history of RCC, initially diagnosed 11 years ago, who presented with a large SM mass. A large mass measuring more than 25 cm was located in left posterior thigh and was present for more than a year. It initially was diagnosed as a large blood clot and was treated with warfarin for more than 6 months. Clinical work up including FDG-PET/CT and MRI raised the possibility of a tumor, but a negative biopsy made the diagnosis uncertain. Because of high suspicion for a tumor, patient underwent a complete resection of the mass. Results The resected mass measuring 28 × 18 × 7 cm was detailed as the largest skeletal muscle metastasis from RCC ever reported. Conclusion This case emphasizes the importance of maintaining a high suspicion for metastasis even in less common metastatic sites mainly in patients with a history of RCC. It also highlights the importance of annual surveillance for metastasis in patients with RCC even after 10 years of initial presentation using FDG-PET/CT.
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Affiliation(s)
- Vipin Lohiya
- Internal medicine, Baptist Health System, 800, Montclair Rd, Birmingham, 35203 Alabama USA
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Chawla A, Mishra D, Bansal R, Chundru M. Rare sites of delayed metastasis in renal cell carcinoma. BMJ Case Rep 2013; 2013:bcr-2013-009971. [PMID: 23813515 DOI: 10.1136/bcr-2013-009971] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Renal cell carcinoma (RCC) is a lethal malignancy with a propensity for metastatic spread to any part of the body. The common sites of metastases from RCC include lungs, adrenals, intestines and brain and most intra-abdominal organs which may present as synchronous or metachronous to the primary tumour. A long follow-up is advised to deal with the risk of delayed metastases even when the primary has been well controlled. There have been few case reports in regard to rare sites of RCC metastasis. In this series of three cases, we present three rarest sites of metastatic RCC reported after 5 years of the primary malignancy.
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Affiliation(s)
- Arun Chawla
- Department of Urology, Kasturba Medical College, Manipal, Karnataka, India.
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11
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D'Elia C, Cai T, Luciani L, Bonzanini M, Malossini G. Pelvic and muscular metastasis of a renal cell carcinoma: A case report. Oncol Lett 2013; 5:1258-1260. [PMID: 23599775 PMCID: PMC3629218 DOI: 10.3892/ol.2013.1172] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 01/04/2013] [Indexed: 11/12/2022] Open
Abstract
We report a case of an uncommon site of metastasis of a renal cell carcinoma. The most common sites of renal cell carcinoma metastasis are the lung, lymph nodes, liver, bone and adrenal glands; skeletal muscle metastasis is a rare occurrence. We report the case of a 75-year-old female who underwent a laparoscopic left radical nephrectomy for a renal neoplasm in 2011. The histological examination revealed the presence of a renal cell carcinoma, Fuhrman grade 2, with extensive necrosis and phlogosis areas (TNM 2009 RCC pT2a). Ten months later, the patient noted an indolent swelling on the proximal third of the right thigh and underwent a ultrasonographic and CT evaluation, documenting the presence of a pathological, solid bulk in the front of the right iliac vessels and in the rectus femoris muscle. The fine needle biopsy revealed a metastasis of renal cell carcinoma. The patient underwent 4 cycles of sunitinib therapy, followed by 3 cycles of salvage therapy with sorafenib, which were well tolerated. This unpredictable behaviour of RCC suggests the need to perform a thorough follow-up of patients.
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Affiliation(s)
- Carolina D'Elia
- Departments of Urology, Santa Chiara Hospital, Trento I-938100, Italy
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12
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Cafferky NL, Malone WJ, Bowen TR. Orthopaedic case of the month: a 72-year-old man with a painful flexion contracture of the left thigh. Clin Orthop Relat Res 2013; 471:346-51. [PMID: 22961317 PMCID: PMC3528914 DOI: 10.1007/s11999-012-2567-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Accepted: 08/15/2012] [Indexed: 01/31/2023]
Affiliation(s)
- Nathan L. Cafferky
- />Department of Orthopaedic Surgery, Geisinger Medical Center, 100 N Academy Avenue, Danville, PA 17822 USA
| | - W. James Malone
- />Department of Radiology, Geisinger Medical Center, Danville, PA USA
| | - Thomas R. Bowen
- />Department of Orthopaedic Surgery, Geisinger Medical Center, 100 N Academy Avenue, Danville, PA 17822 USA
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Tatoğlu MT, Ozülker T, Değirmenci H, Sayιlgan AT. Subcutaneous fatty tissue metastasis from renal cell carcinoma detected with fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography and magnetic resonance imaging. INDIAN JOURNAL OF NUCLEAR MEDICINE : IJNM : THE OFFICIAL JOURNAL OF THE SOCIETY OF NUCLEAR MEDICINE, INDIA 2011; 26:27-30. [PMID: 21969776 PMCID: PMC3180717 DOI: 10.4103/0972-3919.84608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A patient who had undergone left radical nephrectomy 11 years ago for renal cell carcinoma (RCC) was referred to our clinic for restaging. Fluorine-18 fluorodeoxyglucose (F18-FDG) positron emission tomography/computed tomography (F18-FDG PET/CT) showed hypometabolic area in left frontal region of the brain and increased FDG uptake in the subcutaneous fatty tissues of the right thigh. Histopathological examination of the biopsy material from the left frontal region and right gluteal region revealed metastasis of clear cell type RCC. Seven months later, a magnetic resonance ımaging (MRI) of right cruris showed a contrast-enhancing lesion with a diameter of 3.5 cm, located at the subcutaneous area of posterior part of right cruris. A concomitant F18-FDG PET/CT detected an increased FDG uptake focus in the proximal third of right cruris adjacent to the muscle planes and this finding was consistent with metastasis of RCC.
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Affiliation(s)
- Mehmet Tarιk Tatoğlu
- Department of Nuclear Medicine, Okmeydani Training and Research Hospital, Istanbul, Turkey.
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14
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Atypical presentations and rare metastatic sites of renal cell carcinoma: a review of case reports. J Med Case Rep 2011; 5:429. [PMID: 21888643 PMCID: PMC3177931 DOI: 10.1186/1752-1947-5-429] [Citation(s) in RCA: 121] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Accepted: 09/02/2011] [Indexed: 01/08/2023] Open
Abstract
Renal cell carcinoma is a potentially lethal cancer with aggressive behavior and a propensity for metastatic spread. Due to the fact that the patterns of metastases from renal cell carcinomas are not clearly defined, there have been several reports of cases of renal cell carcinoma associated with rare metastatic sites and atypical presenting symptoms. The present review focuses on these atypical rare clinical presentations of renal cell carcinomas both at the time of diagnosis of the primary tumor but also in the years after radical nephrectomy.
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15
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Abstract
Renal cell carcinoma (RCC) causing metastasis to the skeletal muscles is extremely rare. The authors describe a patient with history of RCC treated 5 years ago with radical nephrectomy who presented with left arm swelling after receiving seasonal flu shot. He was initially diagnosed with cellulitis, treated with intravenous antibiotics and discharged home. One month later, he presented with persistent left arm swelling accompanied by wrist drop. Subsequently he developed increased swelling, decreased pulse and wrist drop. He was diagnosed with compartment syndrome, for which fasciotomy was performed, and tissue samples were sent for analysis. Histopathological analysis confirmed metastatic clear cell RCC. The authors described a literature review of previously described cases of metastasis of renal cell cancer to the skeletal muscles. The authors also discussed the rarity of muscle metastasis and unpredictable behavior of RCC after being dormant for long periods.
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16
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Abstract
Skeletal muscle metastasis is a rare event in renal cell carcinoma (RCC). Only thirty-two cases have been reported until now. A 69-year-old female had a nephrectomy for right RCC (clear cell carcinoma, grade 2, pT1) in 1994. She has been followed up every three months after nephrectomy. After twelve years from nephrectomy, computed tomography (CT) showed a 3 cm mass in the right iliopsoas muscle. CT guided needle biopsy revealed tumor cells suspicious of renal cell carcinoma metastasis. The tumor was surgically removed and histologically diagnosed as renal cell carcinoma metastasized to the iliopsoas muscle.
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17
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Domènech A, Rodríguez-Gasén A, Benítez A, Bajén MT, Mora J, Martín-Comín J. [Metastasis of clear-cell renal carcinoma in skeletal muscle]. ACTA ACUST UNITED AC 2008; 27:442-3. [PMID: 19094905 DOI: 10.1016/s0212-6982(08)75533-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A Domènech
- Servicio de Medicina Nuclear, Hospital Universitari de Bellvitge-IDIBELL, Hospitalet de Llobregat, España.
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McCloskey MC, Smyth J, Marshall W, Leonard N. Octreotide scanning in the detection of metastatic renal cell carcinoma. NDT Plus 2008; 1:369-70. [PMID: 25983940 PMCID: PMC4421280 DOI: 10.1093/ndtplus/sfn094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2008] [Accepted: 06/05/2008] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - John Smyth
- Renal Unit , Ulster Hospital , Dundonald, Belfast, Northern Ireland
| | - Wendy Marshall
- Renal Unit , Ulster Hospital , Dundonald, Belfast, Northern Ireland
| | - Niall Leonard
- Renal Unit , Ulster Hospital , Dundonald, Belfast, Northern Ireland
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