Valdespino-Castillo VE, Ruiz-Jaime A

Language: Spanish
References: 12
Page: 339-342
PDF size: 124.83 Kb.

ABSTRACT

Background: Renal cancers represent ~3% of malignant tumors in adults and occur in a M:F ratio (1.5:1.0). Although in most cases it occurs in persons 50 to 70 years of age, there are also reports in children. Clear cell carcinoma is the most frequent histological type and 30% of renal carcinomas have metastasized at the time of diagnosis. The objective of the present study is to report colon metastasis of clear cell carcinoma that required surgery and chemotherapy.
Clinical case: We report the case of a 60-year-old male with a history of metastatic renal cancer. His treatment consisted of cytoreductive radical nephrectomy and interferon because of pulmonary disease. He was followed-up for 8 years. Nevertheless, he presented with hematochezia and underwent colonoscopy where a tumor in the spleen was demonstrated. Biopsy reported a clear cell tumor. We performed a left hemicolectomy. Pathology report was clear cell carcinoma with involvement of the colon from the mucosa to serosa. The patient again received interferon. Currently, there is no evidence of tumoral activity and the patient is being followed-up.
Conclusions: Renal cancer metastases are most frequent in lung, liver, and bone and less frequent in brain, skin, and soft tissue. Metachromic metastases are identified in the first to second year after nephrectomy in most cases. Survival of patients who present metastasis ‹1 year after nephrectomy is 33 months vs. patients who present metastasis after 1 year from nephrectomy (55 months). Metastatic clear cell carcinoma requires surgery and immunotherapy. Surgery is the first step for disease control and metastatecomies are indicated in localized disease or when one organ is affected and surgically accessible.

REFERENCES

1. Linehan W, Bates S, Yang J. Cancer of the genitourinary system. In: Cancer: Principles and Practice of Oncology. 7th ed. Philadelphia: Lippincott Williams & Wilkins;2005. pp. 1139-1168.

2. Castells A, Rustgi A. Tumor invation and metastasis. In: Rustgi A, Craword J, eds. Gastrointestinal Cancers. Philadelphia: Saunders;2003. pp. 69-80.

3. Thyavihally YB, Mahantshetty U, Chamarajanagar RS, Raibhattanavar SG, Tongaonkar HB. Management of renal cell carcinoma with solitary metastasis. World J Surg Oncol 2005;3:48-55.

4. Kozlowski JM. Management of distant solitary recurrence in the patient with renal cancer. Urol Clin North Am 1994;21:601-624.

5. Skinner DG, Colvin RB, Vermillion CD, Pfister RC, Leadbetter WF. Diagnosis and management of renal cell carcinoma: a clinical and pathologic study of 309 cases. Cancer 1971;28:1155-1177.

6. Tongaonkar HB, Kulkarni JN, Kamat MR. Solitary metastases from renal cell carcinoma: a review. J Surg Oncol 1992;49:45-48.

7. Swanson DA. Surgery for metastases of renal cell carcinoma. Scand J Surg 2004;93:150-155.

8. Askin CC, Alfeirán RA, Luevano FE, Ochoa CF. Neoplasias metastásicas al tubo digestivo. Análisis de 14 casos estudiados en el Instituto Nacional de Cancerología. Rev Inst Nac Cancerol 1987;33:483-487.

9. Alfeirán RA, Luevano FE, Alcara PF, Askin CC, Ochoa CF. Hemorragia masiva de tubo digestivo por metástasis de carcinoma de tubo digestivo. Rev Inst Nac Cancerol 1985;31:98-99.

10. Julianov A, Stoyanov H, Karashmalakov A. Late renal metastasis from sigmoid adenocarcinoma. Lancet Oncol 2004;5:726-728.

11. Utsunomiya K, Yamamoto H, Koiwai H, Kirii Y, Kashiwagi H, Konishi F, et al. Solitary colonic metastasis from renal cell carcinoma 9 years after nephrectomy: report of a case. Int J Colorectal Dis 2001;16:193-194.

12. Kibar Y, Deveci S, Sumer F, Seckin B. Renal papillae metastasis of sigmoid colon adenocarcinoma. Int J Urol 2005;12:93-95.