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Báo cáo y học: " Prechronous’ metastasis in clear cell renal cell carcinoma: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Prechronous’ metastasis in clear cell renal cell carcinoma: a case report. | Poon et al. Journal of Medical Case Reports 2011 5 181 http www.jmedicalcasereports.eom content 5 1 181 JOURNALOF medical Ur Case REPORTS CASE REPORT Open Access Prechronous metastasis in clear cell renal cell carcinoma a case report 1 r- I -S 1 1 1 2 2 Eileen Poon Sin Jen Ong Xue En Chuang Wan Teck Lim Nor Azhari Mohd Zam Tsung Wen Chong Issam Al Jajeh3 Kent Mancer4 and Min-Han Tan1 5 Abstract Introduction Although metastatic carcinoma in the presence of an occult primary tumor is well recognized underlying reasons for the failure of the primary tumor to manifest are uncertain. Explanations for this phenomenon have ranged from spontaneous regression of the primary tumor to early metastasis of the primary tumor before manifestation of a less aggressive primary tumor. We report a case of prechronous metastasis arising from clear cell renal cell carcinoma where metastatic disease initially manifested in the absence of a primary renal tumor followed by aggressive growth of the primary renal lesion. Case presentation A 43-year-old Malay man initially presented to our facility with fever and cough. He subsequently underwent surgical resection of a 9 cm right-sided lung mass found on radiological examination. Histology showed a high-grade clear cell tumor with sarcomatoid differentiation suggestive of a metastasis from clear cell renal cell carcinoma. However no concurrent renal lesions were noted on computed tomographic evaluation at that time. Then four months after lung resection he presented with a subcutaneous mass in the left loin as well as right loin discomfort. Computed tomography scanning revealed a 10 cm right renal mass with renal vein and inferior vena cava invasion as well as recurrent disease in the right thorax. Histological examination of the excised subcutaneous mass revealed a high-grade carcinoma consistent with clear cell renal cell carcinoma. Conclusions This is the first reported case of prechronous metastasis of renal cell carcinoma with .