Vaginal Bleeding as Initial Presentation of an Aggressive Renal Cell Carcinoma: A Case Report and Review of the Literature.

Antonio R Jimenez,Maria Del Mar Rivera Rolon,Cecilia Clement,Eduardo Eyzaguirre

doi:10.1155/2018/2109279

Antonio R Jimenez, Maria Del Mar Rivera Rolon + Show 2 more

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https://doi.org/10.1155/2018/2109279

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Abstract

Introduction Renal cell carcinoma is the third most common urogenital cancer. In some patients, it can metastasize to distant organs. Metastasis to the vagina is extremely rare. Case Presentation A 54-year-old female with unremarkable history presented to the clinic with a chief complaint of vaginal bleeding. Further examination identified a pedunculated mass on the vaginal wall. Histologic examination revealed a metastatic clear cell renal cell carcinoma. Radiological studies then revealed a left renal mass and bilateral adrenal masses. The patient underwent a nephrectomy, adrenalectomy, and resection of the vaginal mass. The mass in the vagina has since recurred. ConclusionWe report the first known case of vaginal metastasis as initial presentation of a renal cell carcinoma with rhabdoid features. Postmenopausal women with renal cell carcinoma who present with vaginal bleeding should undergo a thorough inspection of the vaginal wall for the potential of metastatic neoplasms.

Highlights

Renal cell carcinoma is the third most common urogenital cancer
Renal cell carcinoma (RCC) is a malignant neoplasm that originates from the renal tubular epithelium
Immunohistochemistry is helpful in differentiating these entities as carbonic anhydrase 9/IX (CA-IX) and CD10 are most frequently expressed in clear cell RCC (CCRCC) than Mullerian cell carcinomas (CCC), whereas CK7, Napsin-A, and methylacylcoenzyme-A racemase (AMACR) show a reverse pattern of expression [3]

Summary

Introduction

Renal cell carcinoma (RCC) is a malignant neoplasm that originates from the renal tubular epithelium. 60 to 80% of renal cancers are discovered incidentally on imaging studies [1, 2]. The classic presentation of RCC is flank pain, hematuria, and a palpable abdominal mass. This presentation is uncommon and occurs in less than 10% of affected individuals [1]. Literature has identified that approximately 30% of patients with RCC present with metastases at the time of their initial diagnosis. Metastasis of clear cell RCC (CCRCC) to the vagina is extremely rare, with less than 100 reported cases in medical literature

Case Presentation

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