An Uncommon Case of Renal Metastasis from Cervical Cancer

Metastases to the Kidney: An Analysis of 35 Cases and a Review of Literature

Introduction

In addition to being rare, metastases to the kidney present clinicians with issues regarding their treatment.

Materials and Methods

We retrospectively analyzed 35 cases of diagnosed renal metastases. The clinical characteristics, imaging features, pathological features, diagnosis, and treatment were analyzed, and Kaplan-Meier methods and Cox regression analysis were used to calculate overall survival (OS) and influencing factors.

Results

The average age of the patients was 62 years, and 40% presented with symptoms. The most common primary tumor was lung cancer (60%), and two patients had renal metastases coexisting with renal cell carcinoma. The average interval from primary tumor to renal metastasis was 29.4 months. Only 45.5% of the patients who underwent enhanced computerized tomography were diagnosed with renal metastases. Renal biopsy was performed in 16 patients (45.7%), leading to a diagnosis in 15 (93.8%). Twenty-one patients (60%) received surgical treatment, and median recurrence free survival of these patients was 7 months (95% CI, 5 to 12). Overall, the median OS was 44 months for patients who underwent renal surgery, and 52 months for patients who did not (P = 0.672). However, for patients without metastases at other sites, surgery could significantly prolong OS (P = 0.001).

Conclusion

Although rare, the possibility of renal metastasis should be considered after finding renal tumors in patients with primary tumors in other organs, and can be diagnosed by imaging examination and puncture biopsy. For patients without other metastases, surgical intervention can be considered for the renal lesions.

Metastases to the Kidney: A Case Report and Review of the Literature

Renal metastases are uncommon in clinical practice, even as autopsy reports much frequent cases în disseminated tumors. Usually multiple and bilateral, they can determine many problems of differential diagnosis in case of solitary renal mass, when a primary kidney neoplasm must be excluded. Main sources are represented by the tumors of the lung, breast, digestive tract, melanomas and lymphomas, but rare cases with other etiology have been reported. Imaging can help to the diagnosis; CT scan, MRI, transabdominal ultrasound and sometimes contrast enhanced ultrasound can be useful. The treatment is individualized by the general status, by other organs involved and by the control of primary tumors; nephrectomy can be made in cases with unsure diagnosis and if primary tumor is controlled.

Simultaneous Metastasis from Cervical Cancer to the Kidney and Paraspinal Muscle: A Case Report

Metastases of squamous cell carcinoma of the cervix to atypical locations may occur in approximately 12% of patients diagnosed with distant metastases, with the kidney and paraspinal muscle as one of the rarest sites of spread.

A 34-year-old woman with a diagnosis of squamous cell carcinoma of the cervix stage IIIB, treated with chemotherapy and radiation, presented 21 months after completion of therapy, with two sites of simultaneous metastases (kidney and paraspinal muscle). No other evidence of disease was noted. She underwent right nephrectomy and radiotherapy to the para-spinal mass. She did not accept chemotherapy. The patient then had progression of disease in the right nephrectomy bed and a new left renal lesion. The paraspinal lesion presents a partial response. The patient declined further chemotherapy and died five months after the relapse.

Simultaneous metastases of squamous cell carcinoma of the cervix to the kidney and paraspinal region is a rare entity, and there is currently no standard recommendation for treatment.