Renal Metastases from a Nasal Cavity Mixed Squamous Cell and Adenoid Cystic Carcinoma: A Case Report

Abstract

Rare disease Background: Adenoid cystic carcinoma (ACC) is a very rare tumor with a high risk of loco-regional recurrence and potential distant metastases. Until now, only a few cases of renal metastases from ACC have been reported in the literature. Case Report: A 64-year-old, Caucasian, non-smoker female, 8 months after being treated by radio-chemotherapy for a squamous cell nasal cavity tumor, presented two renal lesions associated with lung and vertebral metastases. Histology was consisted with a metastasis from an ACC. The histological revision of the primary nasal tumor confirmed a squamous cells carcinoma with an adenoid cystic component that metastasized to the kidney. Renal lesions appeared hypometabolic at the 18 F-fluorodeoxyglucose (18 F-FDG) PET scan mimicking a primary renal tumor. The patient underwent a systemic, palliative chemotherapy by a weekly carboplatin/paclitaxel/cetuximab regimen that was well tolerated and allowed a lasting tumor control. Conclusions: The particularity of this case relies on the rarity of renal metastasis from ACC, its difficult diagnosis, and the complexity of its management, as no standard chemotherapy has been validated for metastatic ACC, yet. In our case, a weekly carboplatin/paclitaxel/cetuximab regimen was administered leading to a durable tumor stabilization with an excellent patient's quality of life.

A curious case of metastatic parotid adenoid cystic carcinoma to kidney

“…Maissa et al have suggested systemic chemotherapy agents such as cyclophosphamide, cisplatin, 5-fluorouracil and doxorubicin may have some efficacy against metastatic ACCs; however, chemotherapeutic management of renal metastases remains not well defined at present 30. Other treatment approaches such as thermoablation and renal embolisation have been proposed by Longo et al , predominantly from a palliative point of view and for the management of painful lesions 31…”

Exceptional Renal Metastasis from Adenoid Cystic Carcinoma of the Nasal Cavity and Literature Review

“…However, this approach wasn't possible in our case because of the multiplicity of the lesions. Other treatment modalities, such as thermoablation, renal embolization, may be proposed in some patients, especially with painful lesions (6). Systemic chemotherapy with agents, such as cyclophosphamide, cis-platinum, 5 fluouracil, and doxorubin, may have some efficacy against metastatic ACC and must be considered when locoregional treatment is not indicated.…”

99mTc-MIBI SPECT/CT and FDG PET/CT in Isolated Bilateral Renal Metastases From Adenoid Cystic Carcinoma of the Maxilla

“…10 Reports on FDG PET/CT findings of renal metastasis from adenoid cystic carcinoma are limited. 8,9,11 Renal metastasis, especially isolated renal metastasis, may be indistinguishable from renal cell carcinoma on FDG PET/CT. 8,9,[11][12][13] This case indicates metastatic adenoid cystic carcinomas of the kidneys can show photopenia on 99m Tc-MIBI SPECT/CT and increased FDG uptake mimicking primary renal cell carcinoma.…”

“…The lung is the most common site of distant metastasis followed by bone, liver, and brain 7 . Isolated renal metastasis from adenoid cystic carcinoma of the head and neck is extremely rare and may mimic primary renal tumor clinically and radiologically 8,9 . 99m Tc-MIBI SPECT/CT is useful for the characterization of enhancing primary solid renal tumors.…”

“…The FDG PET/CT is helpful in excluding possible regional lymph node or distant metastases in patients with adenoid cystic carcinoma of head and neck 10 . Reports on FDG PET/CT findings of renal metastasis from adenoid cystic carcinoma are limited 8,9,11 . Renal metastasis, especially isolated renal metastasis, may be indistinguishable from renal cell carcinoma on FDG PET/CT 8,9,11–13 .…”