Solitary Metachronous Metastasis of Renal Cell Carcinoma to the Ureter

Cheng, Kwun‐Chung; Cho, Chak‐Lam; Chau, Lysander Hin; Lam, Kin-Mam; So, Hing-Sing

doi:10.5171/2013.854413

Cited by 3 publications

(7 citation statements)

References 10 publications

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“…4 This is the 54th reported case of ureteric metastasis from RCC (43 to the ipsilateral ureter, 10 contralateral). 5 Length of time from nephrectomy to detection of metastasis is twice as long compared to that of other disease subtypes, such as clear cell or papillary RCC, 6 which may explain the late presentation in this case compared to the other reported cases. Chromophobe renal cell carcinoma recurrence in the ureter: A late presentation of a rare metastasis case rePOrT…”

Section: Discussionmentioning

confidence: 69%

Chromophobe renal cell carcinoma recurrence in the ureter: A late presentation of a rare metastasis

Macleod

Kheirandish

Ondego³

et al. 2015

CUAJ

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We describe a case of recurrence of chromophobe renal cell carcinoma 8 years after successful surgical treatment of primary localized disease in the left kidney. The primary tumour had exhibited neither gross nor histological evidence of lymphovascular infiltration. The recurrence occurred in the residual left ureteric stump -a finding that, to the best of our knowledge, has not previously been reported.

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Section: Discussionmentioning

confidence: 69%

Chromophobe renal cell carcinoma recurrence in the ureter: A late presentation of a rare metastasis

Macleod

Kheirandish

Ondego³

et al. 2015

CUAJ

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“…The occurrence of this metastatic event has ranged from a few months up to eight years following radical nephrectomy [ 5 ]. The most common presenting feature is recurrent hematuria, which was seen in our case [ 6 ].…”

Section: Discussionmentioning

confidence: 91%

“…The most plausible explanation for the isolated ureteric metastases could be the retrograde spread of the tumor cells from the renal vein into the ureteral vein, a theory which could be supported by the autopsy findings of bladder metastases in patients with renal vein involvement in a higher percentage (6.1%) as compared to lower risk of such metastases when the renal vein was not involved (1.2%) [6]. There has been a report of the retrograde venous spread of the RCC to the vagina, which could further support the above theory [9].…”

Section: Discussionmentioning

confidence: 96%

“…Several theories have been postulated to explain this unusual pattern of metastases from RCC to the ureter and include blood-borne dissemination, lymphatic spread, and mucosal and submucosal seeding of the urothelium by the cancer cells, which reach the collecting system either by ulceration or direct spread [ 8 ]. The most plausible explanation for the isolated ureteric metastases could be the retrograde spread of the tumor cells from the renal vein into the ureteral vein, a theory which could be supported by the autopsy findings of bladder metastases in patients with renal vein involvement in a higher percentage (6.1%) as compared to lower risk of such metastases when the renal vein was not involved (1.2%) [ 6 ]. There has been a report of the retrograde venous spread of the RCC to the vagina, which could further support the above theory [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

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An Unusual and Rare Metachronous Ipsilateral Ureteric Stump Metastasis Post Radical Nephrectomy

Chalokia¹,

Anosike²,

Robinson³

et al. 2021

Cureus

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We report a case of recurrence of chromophobe renal cell cancer in the ipsilateral ureteric stump eight years later after the primary tumor was excised successfully. Before this detection of the recurrence, the patient had presented with recurrent episodes of hematuria four years after the radical nephrectomy was performed and the investigations were inconclusive. Eventually, the lesion was detected on flexible cystoscopy in the area of the right ureteric orifice protruding in the bladder. Transurethral resection of the tumor surprisingly revealed a chromophobe renal cancer with similar features seen in the primary tumor specimen. The patient underwent robotic-assisted laparoscopic excision of the ureteric stump with a cuff of the bladder and has been recurrence-free for five years on regular surveillance scans.

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“…Renal cell carcinoma (RCC), mainly of the clear cell variety, spreads via hematogenous and lymphatic pathways to the lung, liver and bones. Although, few case reports of renal adenocarcinoma metastasizing to the ureteric stump have been reported, all have been of clear cell carcinoma variety (2). We present the first-ever case of drop metastasis of a rare variant of RCC to the ipsilateral ureter.…”

Section: Introductionmentioning

confidence: 93%

Solitary Metachronous Drop Metastasis of a Rare Variant of Renal Cell Carcinoma to Ipsilateral Ureteric Stump - A Case Report

Agarwal¹,

Yuvaraja²,

Waigankar³

et al. 2023

uob

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Metachronous metastasis of renal cell carcinoma (RCC) to its ureter has been scarcely reported. All such reports have involved clear cell RCC. We report the first ever case of an oncocytic variant of papillary RCC (OPRCC) -an extremely rare variant that spreads to the ipsilateral ureter. A sixty-five-year-old man, diagnosed to have non-metastatic left RCC with renal vein thrombus, underwent radical nephrectomy. Histopathology revealed large cells in papillary and tubular arrangements with abundant granular cytoplasm. On immunohistochemistry, cells strongly expressed Alpha-methylacyl-CoA racemase and were negative for CD10, C-kit, TFE3, and Melan A, hence a diagnosis of OPRCC, type 2 was given. During follow-up six months, he had a fluorodeoxyglucose avid lesion of size 2.8 cm in the proximal aspect of the left ureteric stump. Therefore, we performed robotic excision of the left ureteric stump and bladder cuff with pelvic node dissection. Pathological examination showed a ureteric mass infiltrating the muscularis propria and periureteric adipose tissue with features of OPRCC, similar to the nephrectomy specimen. It was Pax 8 positive with negativity for the urothelial markers Gata 3, uroplakin and p63, consistent with drop metastasis in a known case. Thus, clinicians must bear in mind that ureteric masses are not always of transitional cell variety and non-clear cell RCC can also metastasize to the ureter. This should be considered by pathologists while evaluating kidney specimens showing oncocytic features. This is the first case report of non-clear cell variety of drop metastasis of a rare histological variant of RCC to the ipsilateral ureter.

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Solitary Metachronous Metastasis of Renal Cell Carcinoma to the Ureter

Cited by 3 publications

References 10 publications

Chromophobe renal cell carcinoma recurrence in the ureter: A late presentation of a rare metastasis

Chromophobe renal cell carcinoma recurrence in the ureter: A late presentation of a rare metastasis

An Unusual and Rare Metachronous Ipsilateral Ureteric Stump Metastasis Post Radical Nephrectomy

Solitary Metachronous Drop Metastasis of a Rare Variant of Renal Cell Carcinoma to Ipsilateral Ureteric Stump - A Case Report

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