Surprisingly Late Metastasis of Renal Cell Carcinoma in the Thyroid Gland Detected by Routine Multiparametric Ultrasound

The differential diagnosis of thyroid nodules in patients treated for renal cell carcinoma in the past can be challenging unless they present sonographic features of malignancy. The possibility of metastases to the thyroid gland, even many years after the primary occurrence of the renal tumor, should always be considered. Here, we present the case of a patient diagnosed with metastases of a renal cell carcinoma to the thyroid 22 years after nephrectomy of the left kidney and uneventful follow-up.

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Metastasis of renal cell carcinoma to urinary bladder: A rare case report with review of literature

Journal of Laboratory Physicians ◽

10.4103/jlp.jlp_108_16 ◽

2017 ◽

Vol 9 (04) ◽

pp. 322-324

Author(s):

Saha Arpita ◽

Jain Manoj ◽

Saha Kaushik ◽

Srivastava Anish

Keyword(s):

Renal Cell Carcinoma ◽

Urinary Bladder ◽

Cell Carcinoma ◽

Renal Cell ◽

Review Of Literature ◽

Indian Literature ◽

The Past ◽

Rare Case Report ◽

Bladder Metastasis

AbstractMetachronous metastatic renal cell carcinoma (RCC) to bladder is rare incidence. We report a case of RCC with metachronous metastasis to the urinary bladder occurring 2 years postradical nephrectomy. In a follow‑up for the past 1 year, the patient is doing well. To the best of our knowledge, this case is the second case of bladder metastasis from RCC in the Indian literature. We reviewed literature and discuss the histopathological features of bladder metastasis of RCC.

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Atraumatic Ruptured Giant Renal Tumor

Annals of African Surgery ◽

10.4314/aas.v17i3.9 ◽

2020 ◽

Vol 17 (3) ◽

Author(s):

Gezahen Negusse Ayane ◽

Khutsafalo Kadimo

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Renal Tumor ◽

Left Kidney ◽

Papillary Renal Cell Carcinoma ◽

Abdominal Distension ◽

Emergency Laparotomy ◽

Rare Presentation ◽

Keywords Renal Cell Carcinoma

Massive hemoperitoneum due to spontaneous rupture of renal cell carcinoma is a rare presentation during emergency laparotomy. A 60-year-old female patient presented with severe abdominal pain, nausea, vomiting and abdominal distension. A massive hemoperitoneum secondary to ruptured left kidney tumor was found during laparotomy. Histology confirmed a papillary renal cell carcinoma. Ruptured renal cell carcinoma can be a cause of bleeding into the retroperitoneum space. Emergency sonography and laparotomy are advocated for its management. Keywords: Renal cell carcinoma, Rupture, Complex mass, Nephrectomy, Papillary

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SUN-479 Metastatic Renal Cell Carcinoma (RCC) to the Thyroid: Case Report and Clinical Lesson

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.1451 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Sreedevi Singidi Reddy ◽

Nisha Reddy

Keyword(s):

Renal Cell Carcinoma ◽

Thyroid Gland ◽

Cell Carcinoma ◽

Renal Cell ◽

Renal Mass ◽

Thyroid Nodules ◽

Clear Cell ◽

Renal Tumors ◽

Clinical Series ◽

Thyroid Metastases

Abstract Background: Metastatic neoplasms to the thyroid gland are rare and have been observed more in autopsy series than in clinical series. Case: A 71-year old woman presented for thyroid nodule evaluation which was incidentally noted on CT/PET scan. She was diagnosed with renal cell carcinoma (RCC) stage IV (6.4 cm, left nephrectomy) 4 months prior. She had right hemi-thyroidectomy 30 years prior for a benign nodule. She was clinically and biochemically euthyroid with dysphagia and hoarseness in her voice. Thyroid u/s revealed multiple nodules in the left lobe with a dominant 3.6 x 2.9 x 3.6 cm solid, heterogeneous nodule with grade 3 hypervascularity. History positive for 1 cm right renal mass and multiple pulmonary nodules increasing in size thought to be consistent with metastases. The FNA of the dominant nodule was indeterminate, Bethesda III (AUS), GSC suspicious (Affirma, 50% ROM) with negative malignancy classifiers. Patient underwent completion thyroidectomy, and surgical path was consistent multifocal clear cell renal cell carcinoma (CRCC) with the largest focus of 3 cm based on clear cell features and strong positivity for stains: CK OSCAR, RCC, PAX-8 & CD-10. Patient is currently on Pazopanib post thyroid surgery for 18 months, and is stable with no further increase in the size of lung nodules or right renal mass and negative serial PET scans. Clinical lesson: CRCC represents 3-4% of all adult malignancies and 85% of all primary renal tumors. In clinical series, CRCC is the most frequent source of thyroid metastases and represents 12-34% of all secondary thyroid tumors. About 17% of patients with CRCC have metastatic disease at diagnosis. Metastases can be synchronous or metachronous to the primary tumor. Latency from nephrectomy to diagnosis of thyroid mets varies from 2 months-21.9 years. Metastases can be solitary (more common), multiple or diffuse. Radiological findings typically reveal hypoechoic and vascularized mass on ultrasound and cold on thyroid scan. Metastases to thyroid can pose diagnostic problem and be a source of confusion in cytology interpretation. Metastatic CRCC can simulate morphologically primary thyroid neoplasm such as Hurthle cell neoplasm or thyroid carcinomas with clear cell changes. Metastatic carcinoma within the thyroid gland is negative for thyroglobulin, TTF-1, calcitonin unlike primary thyroid cancer. CRCC is usually positive for periodic acid-Schiff and Oil red O, vimentin, and CD10. The mean survival in patients with CRCC who had thyroidectomy alone or with adjuvant treatment was 3 years. Conclusion: Thyroid metastases should be considered in patients with thyroid nodules and positive history of RCC. The preoperative distinction between primary and secondary tumors is difficult. Immunohistochemistry is a useful method for the evaluation of patients with suspected thyroid nodules.

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Temporal Change in Risk of Metachronous Contralateral Renal Cell Carcinoma: Influence of Tumor Characteristics and Demographic Factors

Journal of Clinical Oncology ◽

10.1200/jco.2002.08.099 ◽

2002 ◽

Vol 20 (9) ◽

pp. 2370-2375 ◽

Cited By ~ 36

Author(s):

Farhang Rabbani ◽

Harry W. Herr ◽

Taghreed Almahmeed ◽

Paul Russo

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Renal Tumor ◽

Demographic Factors ◽

White Men ◽

Initial Diagnosis ◽

Renal Tumors ◽

Tumor Characteristics

PURPOSE: To determine the relative risk (RR) of developing a metachronous contralateral renal tumor after an initial diagnosis of renal cell carcinoma (RCC), with stratification by renal tumor characteristics, demographic factors, and follow-up duration, in order to develop an improved risk-based surveillance strategy. PATIENTS AND METHODS: The 1973 to 1997 Surveillance, Epidemiology, and End Results database was used to determine the observed and expected number of metachronous contralateral renal tumors developing after an initial diagnosis of RCC. RESULTS: A total of 43,483 patients had a first diagnosis of RCC. Contralateral RCC developed subsequently in 155 (0.4%) of 40,049 patients with follow-up who had no synchronous diagnosis of RCC, with 10.81 expected cases (RR, 14.3; 95% CI, 12.2 to 16.8). The respective RRs (and 95% CIs) for contralateral RCC for white men and women were 16.0 (11.1 to 22.3) and 13.7 (7.7 to 22.6) at less than 2 years, 8.8 (5.0 to 14.3) and 10.5 (5.0 to 19.3) at 2 to 5 years, 13.5 (8.1 to 21.0) and 5.1 (1.4 to 13.2) at 5 to 10 years, and 13.0 (6.2 to 23.9) and 13.7 (5.0 to 29.9) at ≥ 10 years, respectively. The RRs were significantly higher in black compared with white men for the first 5 years, with the RRs (and 95% CIs) in the former group of 95.3 (58.2 to 146.7) at less than 2 years and 41.9 (16.8 to 86.3) at 2 to 5 years. CONCLUSION: The incidence of metachronous contralateral RCC is stable on long-term follow-up, suggesting that surveillance of the contralateral kidney should remain rigorous on extended follow-up. Black men are at a significantly higher risk of developing contralateral RCC in the first 5 years of follow-up.

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A systematic review of the characteristics of thyroid metastases from clear cell renal cell carcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e16113 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e16113-e16113

Author(s):

Karam Khaddour ◽

Nadiia Marenych ◽

Jerry X. Liu ◽

Wendy Ward ◽

Theodora Pappa

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Thyroid Nodules ◽

Clear Cell ◽

Lag Time ◽

Thyroid Metastasis ◽

Cell Renal Cell Carcinoma ◽

The Mean

e16113 Background: Thyroid gland is an uncommon site for metastases from clear cell renal cell carcinoma (CCRCC) and literature is scarce. Due to the variable and often long lag time before development of metastases in patients with CCRCC, thyroid nodules may be misdiagnosed initially as benign. This systematic review aims at a better understanding of the nature of these metastases. Methods: A bibliographic search was performed using PubMed (1990-2019), key words being “renal cell carcinoma, thyroid, kidney cancer, clear cell.” 147 cases were analyzed. The patient’s characteristics assessed were: age, sex, stage, size of metastases, lag time, diagnostic modality, initial symptoms, treatment and outcome in last documented follow up. Binary logistic regression, spearman and ANOVA were performed to identify differences between the existing variables. Results: The mean age (±SE) was 64± (10) years in males and 64 (±11) in females. The mean lag time to diagnosis of thyroid metastasis was 8.7 (±6.3) years. Gender distribution of the patients was 46.3% male, 52.4% female. There was a weak correlation between lag time and size of metastases, not statistically significant. Size of metastases was significantly higher in symptomatic patients (6.06±3.51cm) compared to those with painless mass (4.6±0.29cm) and asymptomatic ones (3.93±1.99cm) (p = 0.03). Fine Needle Aspiration (FNA) was diagnostic in 29.4% of cases, 47.1% were non diagnostic. Most patients (80.3%) underwent thyroid surgery. At 1 year follow up, 55.6% of patients operated were alive versus 35.3% who did not have surgery, though this was not statistically significant (p = 0.1). Conclusions: A larger size of thyroid metastasis was more likely to present with symptomatology. A high index of suspicion is warranted when evaluating thyroid nodules in CCRCC patients. There was no significant difference in outcome between patients who underwent surgery and those who did not. With the wider use of immune check-point and tyrosine kinase inhibitors in metastatic CCRCC, surgery may eventually be reserved only for palliative purposes.

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506: A Risk-Adjusted Follow-up for Patients with Stage I and II Renal Cell Carcinoma

The Journal of Urology ◽

10.1016/s0022-5347(18)30746-8 ◽

2007 ◽

Vol 177 (4S) ◽

pp. 169-169

Author(s):

Quoc-Dien Trinh ◽

Pierre I. Karakiewicz ◽

Thierry Lebeau ◽

Dan Lewinshtein ◽

Elie Antebi ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Stage I

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Beyond Promoter: The Role of Macrophage in Invasion and Progression of Renal Cell Carcinoma

Current Stem Cell Research & Therapy ◽

10.2174/1574888x15666200225093210 ◽

2020 ◽

Vol 15 (7) ◽

pp. 588-596

Author(s):

Haibao Zhang ◽

Guodong Zhu

Keyword(s):

Renal Cell Carcinoma ◽

Tumor Microenvironment ◽

Cell Carcinoma ◽

Renal Cell ◽

Cell Formation ◽

Biological Behavior ◽

Tumor Stem Cell ◽

The Past ◽

The Common

Renal cell carcinoma (RCC) is one of the common urologic neoplasms, and its incidence has been increasing over the past several decades; however, its pathogenesis is still unknown up to now. Recent studies have found that in addition to tumor cells, other cells in the tumor microenvironment also affect the biological behavior of the tumor. Among them, macrophages exist in a large amount in tumor microenvironment, and they are generally considered to play a key role in promoting tumorigenesis. Therefore, we summarized the recent researches on macrophage in the invasiveness and progression of RCC in latest years, and we also introduced and discussed many studies about macrophage in RCC to promote angiogenesis by changing tumor microenvironment and inhibit immune response in order to activate tumor progression. Moreover, macrophage interactes with various cytokines to promote tumor proliferation, invasion and metastasis, and it also promotes tumor stem cell formation and induces drug resistance in the progression of RCC. The highlight of this review is to make a summary of the roles of macrophage in the invasion and progression of RCC; at the same time to raise some potential and possible targets for future RCC therapy.

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Characteristics and outcome of pediatric renal cell carcinoma patients registered in the International Society of Pediatric Oncology ( SIOP ) 93‐01, 2001 and UK‐IMPORT database: A report of the SIOP‐Renal Tumor Study Group

International Journal of Cancer ◽

10.1002/ijc.33476 ◽

2021 ◽

Author(s):

Justine N. van der Beek ◽

Janna A. Hol ◽

Aurore Coulomb‐l'Hermine ◽

Norbert Graf ◽

Harm van Tinteren ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

International Society ◽

Pediatric Oncology ◽

Renal Cell ◽

Renal Tumor ◽

Study Group ◽

Tumor Study ◽

Pediatric Renal Cell Carcinoma ◽

Tumor Study Group

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Identification of miR-20a-5p as Robust Normalizer for Urine microRNA Studies in Renal Cell Carcinoma and A Profile of Dysregulated microRNAs

International Journal of Molecular Sciences ◽

10.3390/ijms22157913 ◽

2021 ◽

Vol 22 (15) ◽

pp. 7913

Author(s):

Julia Oto ◽

Raquel Herranz ◽

Emma Plana ◽

José Vicente Sánchez-González ◽

Javier Pérez-Ardavín ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Diagnostic Value ◽

Diagnostic Model ◽

Low Grade ◽

Non Invasive ◽

Good Expression ◽

Independent Cohort

Renal cell carcinoma (RCC) is the third most frequent urinary malignancy and one of the most lethal. Current diagnostic and follow-up techniques are harmful and unspecific in low-grade tumors. Novel minimally invasive markers such as urine microRNAs (miRNAs) are under study. However, discrepancies arise among studies in part due to lack of consent regarding normalization. We aimed to identify the best miRNA normalizer for RCC studies performed in urine samples together with a miRNA profile with diagnostic value and another for follow-up. We evaluated the performance of 120 candidate miRNAs in the urine of 16 RCC patients and 16 healthy controls by RT-qPCR followed by a stability analysis with RefFinder. In this screening stage, miR-20a-5p arose as the most stably expressed miRNA in RCC and controls, with a good expression level. Its stability was validated in an independent cohort of 51 RCC patients and 32 controls. Using miR-20a-5p as normalizer, we adjusted and validated a diagnostic model for RCC with three miRNAs (miR-200a-3p, miR-34a-5p and miR-365a-3p) (AUC = 0.65; Confidence Interval 95% [0.51, 0.79], p = 0.043). let-7d-5p and miR-205-5p were also upregulated in patients compared to controls. Comparing RCC samples before surgery and fourteen weeks after, we identified let-7d-5p, miR-152-3p, miR-30c-5p, miR-362-3p and miR-30e-3p as potential follow-up profile for RCC. We identified validated targets of most miRNAs in the renal cell carcinoma pathway. This is the first study that identifies a robust normalizer for urine RCC miRNA studies, miR-20a-5p, which may allow the comparison of future studies among laboratories. Once confirmed in a larger independent cohort, the miRNAs profiles identified may improve the non-invasive diagnosis and follow-up of RCC.

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