Cavitating Pulmonary Metastases from a Renal Cell Carcinoma

Abstract

Cavitary lung lesions are quite common findings on chest imaging and often pose a diagnostic challenge to the clinicians. We describe a case of a 75-year-old male who presented to the emergency room with hemoptysis. Computed tomography of the chest demonstrated multiple cavitary pulmonary nodules with peripheral groundglass opacities. Bronchoscopy did not reveal any active bleeding source, and washings were negative for malignancy and infectious cause. Computed Tomography guided biopsy of the left lung nodule showed metastatic carcinoma consistent with papillary renal cell carcinoma. This case highlights the unusual presentation of metastatic renal cell carcinoma.

Radiation-Induced Lung Injury—Current Perspectives and Management

“…This group of patients is at a higher risk of infections given their immunosuppressed status due to concurrent or sequential chemotherapy and immunotherapy. Other differences include organizing pneumonia, drug-induced pneumonitis (immune checkpoint inhibitor pneumonitis), e-cigarette or vaping-use associated lung injury (EVALI), thromboembolic disease (SARS-CoV-2 infection also increases the risk of venous thromboembolism), interstitial lung disease, heart failure, lymphangitic carcinomatosis, and progression of malignancy [ 66 , 74 , 75 , 76 , 77 , 78 , 79 , 80 ].…”

Hemoptysis due to a lung metastasis of renal cell carcinoma: A case report

“…We described a case with massive hemoptysis due to lung metastasis of RCC. Hemoptysis usually develops by infectious diseases or primary lung cancer [5] ; however, there have been few reports of lung metastasis as a causal disorder of hemoptysis [6] . As hemoptysis must be managed depending on the kind of causal disorder, lung metastasis should be considered as one of the differential diagnoses of hemoptysis [7] .…”

Multiple pulmonary cavitating nodules in female with endometrium adenocarcinoma history – difficulties in differentiation between metastases, sarcoidosis and sarcoid-like reaction. Case report

“…Our case also exemplifies the difficulties in differential diagnosis between a sarcoid-like reaction, a cavitating form of sarcoidosis, and multiple pulmonary metastases due to endometrial adenocarcinoma. The differential diagnosis of pulmonary cavities is very broad and should include infections (bacterial, mycobacterial, fungal, parasitic), as well as systemic diseases such as malignancies and rheumatic disorders (sarcoidosis -especially the nodular type, Wegner's granulomatosis, granulomatosis with polyangiitis, nodular amyloidosis) [4,9,10]. Septic emboli and subsequent pulmonary vessel thrombosis may result in pulmonary cavities as well.…”

“…Although this kind of process is most characteristic of Staphylococcus aureus and Klebsiella pneumoniae infections, it can also be seen in Streptococcus pneumoniae, Haemophilus influenzae, Actinomyces, Nocardia and Rhodococcus contagions. Pulmonary tuberculosis (caused by Mycobacterium tuberculosis) and pulmonary mycobacteriosis caused by non-tuberculous mycobacteria may also be the reason why cavitating pulmonary nodules mimic metastases, especially among patients that already suffer from pulmonary diseases in countries like Poland with a relatively high annual incidence of tuberculosis [10,11,12]. Among certain patients percutaneous transthoracic needle aspiration may be diagnostically helpful [12].…”