Hepatic Metastasis of Papillary Renal Carcinoma Preoperatively Diagnosed as Cystadenocarcinoma of the Liver: Report of a Case

Abstract

The patient was a 48-year-old man who had been found to have a hepatic tumor 6.6 cm in diameter on a CT scan and was admitted to our hospital for further examination. His past medical history included left nephrectomy for papillary renal cell carcinoma in December 2003. An abdominal CT scan revealed a multilocular cystic mass showed 75 mm in diameter in S7 of the right lobe of liver. Abdominal ultrasonography showed a highly echoic mass 70 mm in diameter in the right lower abdomen. On abdominal MRI a multilocular cystic mass measuring 80 mm×65 mm was seen in S7 of the right lobe of liver, and it was depicted as mild high intensity on the T1-weighted images and very high intensity on the T2-weighted images. Celiac arteriography showed a hypervascular mass in the arterial phase and a tumor stain in the venous phase. Based on these findings, a diagnosis of cystadenocarcinoma of the liver was made, and surgery was performed. Intraoperative exploration revealed that the tumor was located in the right lobe of the liver. Right lobectomy was performed, and macroscopic examination of the surgical specimen showed that the tumor measured 70 mm×70 mm×50 mm. The cut surface was cavenous and brown. The histopathological diagnosis was papillary carcinoma, and the histological findings resembled those of the papillary renal cell carcinoma in the surgical specimen obtained previously. The multilocular cystic mass in the liver misdiagnosed as a cystadenocarcinoma of the liver was a metastasis from the papillary renal carcinoma in the previous surgical specimen.