Abstract
A 51-year-old male with a long history of tobacco smoking presented to the outpatient clinic with left renal colic. A renal ultrasound revealed a mass in the left kidney. The patient was admitted to surgical clinic of Russian Scientific Center of Roentgen-Radiology of Rosmedtechnology. A renal biopsy and subsequent histopathological tests revealed adenocarcinoma of the right kidney of most likely metastatic origin. This discovery has lead to vigorous diagnostics search for the primary tumor. Finally, the following diagnosis was established: Primarily-multiple synchronous cancer: cancer of the left kidney T1N0M0, cancer of the thyroid gland T2N0M1, metastasis to the right kidney and lungs. The patient had left kidney and thyroid gland removed and was successfully treated with radioiodine therapy. The patient remains alive and well 7 months since his admission to our clinic. We report this case to emphasize the importance of the renal biopsy and thorough histological analysis, which made it possible to diagnose thyroid cancer in this patient.
Highlights
Renal cell carcinoma is a widespread disease. It ranked at the 10th place among malignant neoplasms in humans and is the third most prevalent malignant neoplasms of genitourinary system
Histological study showed a malignant node that had renal cell carcinoma structure with clear cell and papillary components; the node was removed within normal tissues (Figure. 5)
Histological study showed that among abundance of erythrocytes there is a group of hemosiderophages and a complex of cells with polymorphic nuclei and single mitosis that represent papillary structures of papillary cancer
Summary
Renal cell carcinoma is a widespread disease. It ranked at the 10th place among malignant neoplasms in humans and is the third most prevalent malignant neoplasms of genitourinary system. Many clinics in our country do not perform renal biopsy at all and totally relay on imaging methods for diagnosing kidney cancers. Contrast CT of the kidneys showed a hypoechogenic 80 × 60 mm mass with irregular margins in the middle-lower segment of the right kidney. The mass distorted major calyces, renal pelvis, and the contours of the right kidney and accumulated a contrast. Histological study of biopsy specimens concluded that the tumor of the right kidney is presented by adenocarcinoma that probably has metastatic origin; the tumor of the left kidney is renal cell carcinoma (Figure 3, 4). Histological study showed a malignant node that had renal cell carcinoma structure with clear cell and papillary components; the node was removed within normal tissues
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