1. Case report of a patient with a rare location of renal cell carcinoma metastasis
- Author
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Damir Grebić, Ana Marija Tomasić, Daniel Victor Šimac, Zlatko Kolić, Ana Gavranić, David Bonifačić, Damir Grebić, Ana Marija Tomasić, Daniel Victor Šimac, Zlatko Kolić, Ana Gavranić, and David Bonifačić
- Abstract
Aim: Renal cell carcinoma is one of the deadliest cancers, takes third place among malignant carcinomas of the genitourinary tract. This case report describes the rare case of a large fast-growing metastasis of renal cell cancer in an unusual location with short time of its appearance, but with unexpected clinical course after its treatment. Case report: A 60-year-old female patient presented with a fist-sized formation on the scalp. During physical examination, the mass was determined to be firm, infiltrative, fixed, and painless upon palpation. The formation had appeared a month prior to arrival, characterized by fast growth. The patient underwent a radical nephrectomy six months earlier due to RCC. A cranial radiogram showed osteolysis of the neurocranium, while an MRI of the brain confirmed the mass belonged to the scalp, no brain infiltration, measuring 82 x 60 x 74 mm. Fine needle aspiration isolated malignant cells of an adenocarcinoma, origin undetermined. The patient underwent surgery to remove the mass along with the effected neurocranium, and the resulting bone defect was reconstructed using Palacos. Postoperative recovery went well, and the pathohistological analysis confirmed renal cancer metastasis. PET-CT didn’t show suspicious lesions for distal metastasis for a period of 2 years. Conclusion: Renal cell carcinoma commonly metastasizes to the lung. This case report presents the rare case of a large fast-growing renal cancer metastasis to an unusual location, with short time for metastasis appearance. In spite of that we have showed two years follow up of remission., Cilj: Karcinom bubrega zauzima treće mjesto među malignih tumorima genitourinarnog trakta. Cilj ovog prikaza slučaja je opisati rijedak slučaj gigantske i brzorastuće metastaze ovog karcinoma te rijetko mjesto njezinog sijela sa kratkim vremenom njezinog pojavljivanja i neočekivanim kliničkim tijekom nakon njezinog liječenja. Prikaz slučaja: 60-godišnja žena dolazi radi tvorbe u predjelu mekog oglavka glave veličine šake. Prilikom pregleda tvorba se očitovala kao tvrda infiltrativna, fiksirana za podlogu i palpatorno bezbolna. Tvorba se pojavila mjesec dana pred dolazak te se očitovala vrlo brzim rastom i napredovanjem. Kod bolesnice je šest mjeseci unatrag bila učinjena radikalna nefrektomija zbog karcinoma bubrega. Kraniogram je pokazao osteolizu skeleta neurokranijuma, a MR mozga je navedeno potvrdio a tvorba je pripadala mekog oglavku glave bez infiltracije parenhima mozga i mjerila je 82 x 60 x 74 mm. Citološkom punkcijom nađene su maligne stanice adenokarcinoma, ali nije razjašnjeno porijekto istih. Bolesnica je bila podvrgnuta neurokirurškoj operaciji kojom se uklonila ekspanzivna tvorba uz resekciju skeleta neurokranija, a koštani defekt se rekonstruirao sa palakosom. Postoperativni tijek protekao je uredno, a PH nalaz je pokazao da se radilo o metastazi karcinoma bubrega. PET-CT nije pokazao udaljene metastaze u periodu praćenja od dvije godine. Zaključak: Karcinom bubrega najčešće metastazira u pluća. Ovim radom prikazan je rijedak slučaj velike brzorastuće metastaze karcinoma bubrega neobičnog i rijetkog sijela metastaziranja uz kratko vrijeme pojavljivanja metastaze. Unatoč tome kliničkim praćenjem prikazan je period dvije godine remisije.
- Published
- 2018