Isolated Splenic Metastasis from Renal Cell Carcinoma: Case Report and Review

Abstract

This report presents the case of a 70-year-old woman with a previous history of a left nephrectomy for renal cell carcinoma (RCC), who developed general malaise and fatigue. Abdominal computed tomography demonstrated an enhancing 6 × 7 cm necrotic lesion in the lower pole of the spleen suggestive of a metastasis. Given the highly suspicious nature of the lesion we proceeded to splenectomy. The tumour did not breach the splenic capsule, and there was no local diaphragmatic involvement. The mass was concluded to be a true metastasis of the original RCC rather than local recurrence of the disease. The causes of isolated solid splenic lesions are wide and varied, however a past or present history of malignancy should lead to a high index of suspicion for a splenic metastasis. We report an extremely unusual case of spread from a RCC.

Isolated Splenic Metastases from Renal Cell Carcinoma 11 Years after Surgery

“…The majority of the renal primary tumors was in the left kidney (10/14, 71%), which led to a hypothesis of direct spread of the tumor cells rather than haematogenous metastasis; however, the Gerota's fascia was intact in the majority of the tumors [10] similar to our case which suggests that it is an isolated metastasis rather than a case of local recurrence. Patients with splenic metastases from RCC were asymptomatic (6/14, 43%) or had abdominal pain or constitutional symptoms, such as fever, fatigue, weight loss, and anemia.…”

Isolated splenic metastasis from clear cell renal carcinoma – A case report

“…Although incidence of metastatic spread from renal cell carcinoma has been reported to be 4.6% in an autopsy series [5], there are only a few case reports of isolated splenic metastasis in RCC in literature. Detection of splenic metastasis is clinically important for the staging and treatment planning of disease, and high tumor burden may lead to sudden death due to splenic rupture [2], [3].…”

Metastatic Renal Cell Carcinoma: Radiologic Findings and Assessment of Response to Targeted Antiangiogenic Therapy by Using Multidetector CT

“…Other Atypical Metastatic Sites.-RCC metastases to the spleen are very uncommon, are asymptomatic, and generally indicate late spread of the disease. Isolated splenic lesions are extremely uncommon, with less than 25 cases described in the literature (50). Pleural metastases usually appear in patients with metastatic lung involvement, and pleural involvement occurs secondary to direct invasion by parenchymal lung lesions (51).…”