Metastatic renal cell carcinoma of unknown primary site. Clinical follow-up

Renal cell cancer metastases without evidence of a primary tumor are extremely rare. These variants are usually showed as a spontaneous description of single clinical cases. Aim.This contribution is a clinical follow-up of synchronous renal cell cancer metastases of unknown primary site. Resul...

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Autores principales:	N. A. Ognerubov, T. S. Antipova, G. E. Gumareva
Formato:	article
Lenguaje:	RU
Publicado:	IP Habib O.N. 2020
Materias:	renal cell carcinoma metastases without evidence of a primary site surgical treatment targeted therapy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/ac4c2eb834ec4a47b86d15c82a602343
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spelling	oai:doaj.org-article:ac4c2eb834ec4a47b86d15c82a6023432021-11-30T17:03:34ZMetastatic renal cell carcinoma of unknown primary site. Clinical follow-up1815-14341815-144210.26442/18151434.2020.3.200301https://doaj.org/article/ac4c2eb834ec4a47b86d15c82a6023432020-11-01T00:00:00Zhttps://modernonco.orscience.ru/1815-1434/article/viewFile/52652/36091https://doaj.org/toc/1815-1434https://doaj.org/toc/1815-1442Renal cell cancer metastases without evidence of a primary tumor are extremely rare. These variants are usually showed as a spontaneous description of single clinical cases. Aim.This contribution is a clinical follow-up of synchronous renal cell cancer metastases of unknown primary site. Results.A 52-year-old patient U. with a history of increased blood pressure, up to 170/100 mmHg for the last 5 years, who had undergone many instrumental examinations, including ultrasound examination, because of this disease. The computed tomography of the abdomen showed a 4975 mm heterogeneous tumor in the right adrenal gland in October 2017. The combined positron emission and X-ray computed tomography showed a 795441 mm mass in the right adrenal gland, associated with elevated fluorodeoxyglucose metabolic activity SUVmax 7.25. Focal accumulation of the radiopharmaceutical SUVmax 4.31 in a 171124 mm mass was detected in the space of bifurcation in the mediastinum. The lytic lesion (1015 mm) was found in right superior L3 articular process. The patient underwent retroperitoneoscopic adrenalectomy and thoracoscopic removal of mediastinal tumor in November 2017 because of the oligometastatic nature of the process. The histological study identified clear-cell carcinoma with areas of papillary structure in the right adrenal gland. The immunohistochemical study showed carcinoma cells intensively expressing CD10, and some other cells RCC. The immune phenotype of the tumor was identified as clear-cell renal cell carcinoma. The immunohistological and immunohistochemical analysis reviled the metastases of the same variant of renal cell carcinoma in one of 9 lymph nodes. The patient was treated with pazopanib. The primary renal tumor was not detected during the dynamic observation, including the application of annual combined positron emission and X-ray computed tomography. The patient is alive without disease progression with a follow-up of 32 months. Conclusion.Metastases of clear-cell renal cell carcinoma, including adrenal gland, without evidence of a primary site are extremely rare. The main method of treatment is a combination of surgery and targeted therapy, providing long-term local control of the course of the disease.N. A. OgnerubovT. S. AntipovaG. E. GumarevaIP Habib O.N.articlerenal cell carcinomametastases without evidence of a primary sitesurgical treatmenttargeted therapyNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282RUСовременная онкология, Vol 22, Iss 3, Pp 149-153 (2020)
institution	DOAJ
collection	DOAJ
language	RU
topic	renal cell carcinoma metastases without evidence of a primary site surgical treatment targeted therapy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	renal cell carcinoma metastases without evidence of a primary site surgical treatment targeted therapy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 N. A. Ognerubov T. S. Antipova G. E. Gumareva Metastatic renal cell carcinoma of unknown primary site. Clinical follow-up
description	Renal cell cancer metastases without evidence of a primary tumor are extremely rare. These variants are usually showed as a spontaneous description of single clinical cases. Aim.This contribution is a clinical follow-up of synchronous renal cell cancer metastases of unknown primary site. Results.A 52-year-old patient U. with a history of increased blood pressure, up to 170/100 mmHg for the last 5 years, who had undergone many instrumental examinations, including ultrasound examination, because of this disease. The computed tomography of the abdomen showed a 4975 mm heterogeneous tumor in the right adrenal gland in October 2017. The combined positron emission and X-ray computed tomography showed a 795441 mm mass in the right adrenal gland, associated with elevated fluorodeoxyglucose metabolic activity SUVmax 7.25. Focal accumulation of the radiopharmaceutical SUVmax 4.31 in a 171124 mm mass was detected in the space of bifurcation in the mediastinum. The lytic lesion (1015 mm) was found in right superior L3 articular process. The patient underwent retroperitoneoscopic adrenalectomy and thoracoscopic removal of mediastinal tumor in November 2017 because of the oligometastatic nature of the process. The histological study identified clear-cell carcinoma with areas of papillary structure in the right adrenal gland. The immunohistochemical study showed carcinoma cells intensively expressing CD10, and some other cells RCC. The immune phenotype of the tumor was identified as clear-cell renal cell carcinoma. The immunohistological and immunohistochemical analysis reviled the metastases of the same variant of renal cell carcinoma in one of 9 lymph nodes. The patient was treated with pazopanib. The primary renal tumor was not detected during the dynamic observation, including the application of annual combined positron emission and X-ray computed tomography. The patient is alive without disease progression with a follow-up of 32 months. Conclusion.Metastases of clear-cell renal cell carcinoma, including adrenal gland, without evidence of a primary site are extremely rare. The main method of treatment is a combination of surgery and targeted therapy, providing long-term local control of the course of the disease.
format	article
author	N. A. Ognerubov T. S. Antipova G. E. Gumareva
author_facet	N. A. Ognerubov T. S. Antipova G. E. Gumareva
author_sort	N. A. Ognerubov
title	Metastatic renal cell carcinoma of unknown primary site. Clinical follow-up
title_short	Metastatic renal cell carcinoma of unknown primary site. Clinical follow-up
title_full	Metastatic renal cell carcinoma of unknown primary site. Clinical follow-up
title_fullStr	Metastatic renal cell carcinoma of unknown primary site. Clinical follow-up
title_full_unstemmed	Metastatic renal cell carcinoma of unknown primary site. Clinical follow-up
title_sort	metastatic renal cell carcinoma of unknown primary site. clinical follow-up
publisher	IP Habib O.N.
publishDate	2020
url	https://doaj.org/article/ac4c2eb834ec4a47b86d15c82a602343
work_keys_str_mv	AT naognerubov metastaticrenalcellcarcinomaofunknownprimarysiteclinicalfollowup AT tsantipova metastaticrenalcellcarcinomaofunknownprimarysiteclinicalfollowup AT gegumareva metastaticrenalcellcarcinomaofunknownprimarysiteclinicalfollowup
_version_	1718406401046347776

Metastatic renal cell carcinoma of unknown primary site. Clinical follow-up

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