Abstract
We describe the rare case of a 68-year-old gentleman with the history of a hand-assisted laparoscopic left radical nephrectomy for a T2bN0M1 clear cell renal cell carcinoma (RCC). Seven years after surgery and with clean surveillance imaging for metastasis/recurrence the patient presented with three separate tumors suspicious for malignancy. A bladder lesion was found during workup for hematuria, a stomach lesion during diagnostic endoscopy, and a testicular lesion during self-exam. He underwent transurethral resection of bladder tumor, left inguinal orchiectomy, and upper endoscopic ensnarement. All specimens surprisingly showed RCC by histology and immunostaining. These three sites are rare for RCC metastasis and simultaneous presentation is even rarer, further emphasizing the importance of continuous and careful follow-up in this patient population, despite what could appear as complete remission.
Highlights
Renal cell carcinoma has a strong potential to metastasize to multiple organs [1]
We report a rare case of simultaneous presentation of RCC metastasis to the stomach, bladder, and ipsilateral left testicle 7 years after left nephrectomy for clear cell renal cell carcinoma (RCC)
A 68-year-old gentleman with a history of T2bN0M1 clear cell RCC status after hand-assisted laparoscopic left radical nephrectomy, 7 years ago, without evidence of recurrence on surveillance imaging presented with a palpable left testicular mass
Summary
Renal cell carcinoma has a strong potential to metastasize to multiple organs [1]. The most common sites of renal cell carcinoma metastasis are the liver, brain, bones, and lung. Stomach metastasis is very rare (0.2ā4%) and testicular metastasis even rarer (0.1ā1%) [2, 3]. The time to metastasis generally occurs years beyond primary cancer presentation. In testicular metastasis, it usually occurs simultaneously or precedes the diagnosis of renal tumors [4]. We report a rare case of simultaneous presentation of RCC metastasis to the stomach, bladder, and ipsilateral left testicle 7 years after left nephrectomy for clear cell renal cell carcinoma (RCC)
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