Extremely Delayed Multiple Brain Metastases from Renal Cell Carcinoma: Remission Achieved with Total Surgical Removal: Case Report and Literature Review

Fukushima, Yuta; Yoshikawa, Gakushi; Takasago, Megumi; Shimizu, Satoshi; Tsutsumi, Kazuo

doi:10.1016/j.wneu.2016.05.065

Cited by 8 publications

(10 citation statements)

References 17 publications

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“…These metastases appear more indolent than the earlier manifestation of this disease. A recent review of late-onset intracranial metastases from renal cell carcinoma demonstrated total remission after surgical resection of the metastases, further illustrating the atypical clinical course observed in this group of patients [14]. As the choroidal metastasis in this case presented 4 years after nephrectomy, it may not qualify as delayed-onset, but the patient's clinical course supports its similarity to the delayed phenotype.…”

Section: Discussionmentioning

confidence: 70%

Choroidal Melanoma Mimicker: A Case of Metastatic Clear-Cell Renal Cell Carcinoma

Komanski¹,

Rubino²,

Meyer³

et al. 2017

Ocul Oncol Pathol

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Choroidal melanoma is the most common primary intraocular malignancy, yet metastatic disease remains the most common malignancy of the eye. Differentiating these entities is essential as treatment, systemic associations, and prognosis vary dramatically between the two. Established diagnostic criteria are accurate for the diagnosis of uveal melanoma. Yet, metastatic disease may be misdiagnosed as a uveal melanoma in rare cases. We report a case of metastatic clear-cell renal cell carcinoma masquerading as uveal melanoma. A 73-year-old Caucasian man with a history of renal cell carcinoma presented with a 15 × 12 × 7 mm homogenous, pigmented, and acoustically hollow mass without hemorrhage or exudation. The patient was initially treated with plaque radiotherapy with good tumor regression. However, the patient developed pain and vision loss due to total exudative retinal detachment. Subsequent enucleation allowed histopathologic confirmation of clear-cell renal cell carcinoma. Nine years following enucleation, the patient remains in complete remission without evidence of other systemic metastases. Renal cell carcinoma should be considered when evaluating patients with probable uveal melanoma. Delayed-onset ocular metastasis from renal cell carcinoma exhibits an atypical clinical course with the possibility of durable remission following enucleation.

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Section: Discussionmentioning

confidence: 70%

Choroidal Melanoma Mimicker: A Case of Metastatic Clear-Cell Renal Cell Carcinoma

Komanski¹,

Rubino²,

Meyer³

et al. 2017

Ocul Oncol Pathol

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“…[ 18 ] Extremely delayed distant metastasis of RCC, over 10 years after nephrectomy, is not very rare, with a prevalence of 4.7% to 11%. [ 2 ] The most common metastatic sites of RCC are the lungs, lymph nodes, bone, and liver. [ 19 , 20 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 16 , 20 ] Similar to the cases of distant metastasis to other parts other than the brain, the prognosis of brain metastasis from RCC is poor; the median overall survival time after a diagnosis of brain metastasis was 10.7 months, and the 5-year survival rate was 12%. [ 20 ] To the best of my knowledge, a total of 20 cases of extremely delayed brain metastases from RCC have been reported in English so far, [ 2 – 17 ] making it a rare occurrence; all 21 cases including the present case are listed in Table 1 . The cases summarized in Table 1 were searched by various combinations of search terms such as ‘brain or cerebral’, ‘late or delayed’, ‘metastasis or metastatic’, ‘renal or renal cell carcinoma’ and ‘nephrectomy’ in databases such as PubMed, Scholar Google, and Embase, and also referred to the lists summarized published paper.…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 ] It is observed that extremely delayed distant metastasis that occurs in other organs including the lung, bone, and liver 10 years after nephrectomy for RCC is not rare, with a prevalence of 4.7% to 11%. [ 2 ] However, few cases of extremely delayed metastasis to the brain, occurring more than 10 years after the initial diagnosis of RCC, have been reported, [ 2 – 17 ] and the mechanism of delayed metastasis is not clearly known. Here, we report a case of extremely delayed solitary brain metastasis of RCC with lymph node metastasis that occurred 15 years after nephrectomy.…”

Section: Introductionmentioning

confidence: 99%

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Extremely delayed solitary cerebral metastasis in patient with T1N0M0 renal cell carcinoma after radical nephrectomy

Choo¹,

Seo²,

Choi

2021

Medicine

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Rationale: Although renal cell carcinoma (RCC) is one of the common origins of brain metastasis, few cases of extremely delayed brain metastasis from RCC, more than 10 years after nephrectomy, have been reported. We present a rare case of extremely delayed brain metastasis from RCC, also performed a literature review to increase knowledge of the characteristics for extremely delayed brain metastasis from RCC. Patient concerns: A 72-year-old man presented with right-sided hemiplegia and dysarthria. The patient had a history of radical nephrectomy for RCC with stage T1N0M0 15 years earlier. Diagnosis: Magnetic resonance imaging with contrast revealed a 2-cm sized non-homogenous enhanced mass in the left frontal lobe with peritumoral edema. The pathological examination after surgery reported metastatic clear cell RCC. Interventions: A craniotomy for removal of the mass was performed at the time of diagnosis. Stereotactic radiosurgery was performed for the tumor bed 3 weeks after craniotomy, and then, chemotherapy was started 2 months after the SRS. Outcomes: Metastasis progressed to multiple organs 6 months after the craniotomy. The patient chose a hospice and no longer visited the hospital. Lessons: In cases with a history of nephrectomy for RCC, long period follow-up is necessary for monitoring RCC brain metastasis and pathologic diagnosis should be confirmed.

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“…Surgical resection of the primary renal tumor remains the current standard treatment for localized or locally advanced ccRCC. Approximately 25–30% of ccRCC patients present with metastatic disease at initial diagnosis, while 50% develop metastases after removal of the primary tumors, some at very late time points (20–30 years after surgery) [ 14 , 15 ]. Clinical trials investigating the importance of nephrectomies in metastatic ccRCC are underway, and the role of nephrectomy in metastatic ccRCC is an evolving topic of discussion.…”

Section: Introductionmentioning

confidence: 99%

Molecular and Metabolic Subtypes in Sporadic and Inherited Clear Cell Renal Cell Carcinoma

Czyzyk-Krzeska

Figueroa

Gulati

et al. 2021

Genes

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The promise of personalized medicine is a therapeutic advance where tumor signatures obtained from different omics platforms, such as genomics, transcriptomics, proteomics, and metabolomics, in addition to environmental factors including metals and metalloids, are used to guide the treatments. Clear cell renal carcinoma (ccRCC), the most common type of kidney cancer, can be sporadic (frequently) or genetic (rare), both characterized by loss of the von Hippel-Lindau (VHL) gene that controls hypoxia inducible factors. Recently, several genomic subtypes were identified with different prognoses. Transcriptomics, proteomics, metabolomics and metallomic data converge on altered metabolism as the principal feature of the disease. However, in view of multiple biochemical alterations and high level of tumor heterogeneity, identification of clearly defined subtypes is necessary for further improvement of treatments. In the future, single-cell combined multi-omics approaches will be the next generation of analyses gaining deeper insights into ccRCC progression and allowing for design of specific signatures, with better prognostic/predictive clinical applications.

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Extremely Delayed Multiple Brain Metastases from Renal Cell Carcinoma: Remission Achieved with Total Surgical Removal: Case Report and Literature Review

Cited by 8 publications

References 17 publications

Choroidal Melanoma Mimicker: A Case of Metastatic Clear-Cell Renal Cell Carcinoma

Choroidal Melanoma Mimicker: A Case of Metastatic Clear-Cell Renal Cell Carcinoma

Extremely delayed solitary cerebral metastasis in patient with T1N0M0 renal cell carcinoma after radical nephrectomy

Molecular and Metabolic Subtypes in Sporadic and Inherited Clear Cell Renal Cell Carcinoma

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