Oral Squamous Cell Carcinoma Metastases to the Kidneys: Is It Common?

Abstract

Metastases to the kidneys are rare and are frequently erroneously diagnosed as primary renal tumour. The kidney is unusual site of metastatic disease and is the fifth most common site of metastases in the body after lung, liver, bone and adrenals. A 42-year-old male known case of operated buccal carcinoma of cheek (squamous cell carcinoma) presented with complaints of upper abdominal discomfort. Patient was investigated with Computed Tomography (CT) scan outside for the same and was detected to have multiple space occupying lesions in lungs, liver and both kidneys [Table/Fig-1a-c]. For characterization of these lesions patient was referred to us. In our institute patient underwent contrast-enhanced Magnetic Resonance Imaging (CE-MRI). On T2-weighted and CE-MRI images, multiple lesions were detected in liver, bilateral kidneys and left adrenal. Lesions in kidneys were multicentric, appeared as ‘black holes’ on MRI and showed restriction on Diffusion-weighted images [Table/Fig-2,​,3].3]. The imaging was classical in keeping with metastases involving the liver, kidney and left adrenal gland. [Table/Fig-1a-c]: (a) Axial contrast-enhanced CT scan of neck showing fat graft (arrow) in a case of operated squamous cell carcinoma buccal mucosa (b) Lung window sections showing cavitating and solid lung metastases (arrows) (c) Coronal contrast-enhanced MRI image showing ... [Table/Fig-2a,b]: (a) Coronal MR-FIESTA sequence showing hypointense black hole lesions (arrows) in bilateral kidneys (b) Coronal contrast-enhanced MRI image hypo enhancing black hole lesions (arrows) better [Table/Fig-3a-f]: (a-c) Axial MR diffusion-weighted images showing bright lesions (arrows) in liver, left adrenal and bilateral kidneys (d-f) corresponding ADC maps MR image showing lesions appearing dark (arrows) suggestive of diffusion restriction