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Objectives: To report a new case of late renal cell carcinoma recurrence., Methods: Renal cell carcinoma represents approximately 3% of all adult malignancies. The most frequent metastatic sites are lung (76%), regional lymph nodes (66%), bone (42%), and liver (41%), and it is the third most common infraclavicular neoplasm to metastasize to head and neck., Results: 73 year-old man with a 1 week history of recurrent epistaxis. He underwent left nephrectomy 17 years before due to a renal mass of 8.5 cm in the upper pole of the left kidney. The histological diagnosis of the referred mass was clear cell carcinoma. No metastatic lesion was found at that time (Stage I, pT2N0M0). CT scan showed a mass in the right nasal cavity, invading the right ethmoidal sinus and the right orbit. Examination under general anaesthesia and biopsy was performed revealing metastasis of a renal cell carcinoma., Conclusions: The natural history of renal cell carcinoma is highly variable, metastases may present decades after the removal of the primary disease, however, only 1% of patients with renal cell carcinoma have metastases confined only to the head and neck, and solitary cervical metastatic mass is rare. Moreover, renal cell carcinoma should be considered in the differential diagnosis of any growing lesion in the head and neck.

Objectives: To evaluate the reason for diagnosis of renal cell carcinoma and its variation over the years in Radiology 1 and Urology 1 departments of the Asturias Central Universitary Hospital (HUCA) comparing periods 1970-1995 and 1996-2005 and determine whether incidental findings may explain in an independent the prognosis of these tumors or it is dependent on its clinicopathologic characteristics., Material and Methods: We conducted retrospectively, an exhaustive review of medical records of 373 renal cell carcinoma patients that underwent surgical resection during the period 1970-2005, collecting data according to a set protocol., Results: Of the 373 tumors in our series, 146 (39,1%) were diagnosed according to our criteria incidentally, while 227 (60,9%) were diagnosed due to clinical suspicion of a tumor presence. We observed a significant increase in the number of tumors incidentally diagnosed in the second period, when we performed the counting distributing these patients into two groups, firstly those diagnosed between the years 1970-1995 and, secondly, those diagnosed between 1996-2005. We found metastasis, microvascular invasion of surgical piece and treatment of the recurrence as independent factors for specific cancer survival, while nuclear grade, the presence of lymphadenopathies and T3 stage were found as independent factors for recurrence., Conclusions: Classically renal cell carcinoma was diagnosed when local symptoms were present (hematuria and back pain, were the most common), symptoms associated with metastasis, or the expression of a paraneoplastic syndrome. The discovery of asymptomatic renal cell carcinomas has dramatically increased, since the widespread use of ultrasound and computed tomography (CT) in the study of abdominal pathology. It is worth mentioning that, in our study, although patients diagnosed with incidental tumors had a longer time free to recurrence and survival, however, the presence of clinic was not an independent risk factor for recurrence or cancer-specific survival.

Objective: We report one case of ovarian metastasis secondary to a renal clear cell carcinoma., Methods/results: 52 year-old consulting for metrorrhagia with the initial diagnosis of primary ovarian carcinoma. Tumor dissemination work up tests reported a renal mass suggestive of ovarian metastasis. Surgery included hysterectomy, double annexectomy, and radical nephrectomy. Final diagnosis was renal clear cell carcinoma with ovarian metastasis., Conclusions: Metastases to the ovary pose a diagnostic problem in their interpretation, especially when they show a similar histology to the primary ovarian tumor. Due to therapeutic and prognostic implications, it is very important to differentiate if it is a primary ovarian tumor or a metastasis from a renal carcinoma.

Objective: To report a new case of renal metastasis from an squamous cell carcinoma of the lung., Methods: A 60 year old male presented to the outpatient office with an ultrasound finding of renal mass., Results: Imaging test studies showed a heterogeneous mass in the upper pole of the left kidney, involving the pelvis and trapping the renal artery., Conclusions: Clinically recognised or symptomatic metastases to the kidney from pulmonary cancer have been a rare occurrence. Nevertheless, prognosis associated with lung carcinoma metastatic to the kidney is very poor, since the likelihood of a truly solitary metastasis is remote.

Objective: [corrected] To report a rare case of secondary testicular plasmocytoma in the context of a testicular mass., Method: We introduced a patient with plasmocytoma and a testicular infiltration of his systemic affection., Result: An inguinal orquiectomy was performed to treat the testicular infiltration and no recurrence of the process was seen after 6 months of follow up., Conclusions: Plasmacytoma is a plasma cell tumor that involves bone marrow or extramedullary sites. Testicular infiltration by plasma cells such as plasmacytoma happens in only 2% of cases of all plasma cell neoplasm

Objective: The aim of this case report is to add to the literature a new case of renal actinomycosis, but with a form of presentation that has never been reported: renal tumor with retroperitoneal bleeding., Methods/results: We present the case of a 27-year-old woman, with a 5-month history of general syndrome and right flank pain. Radiological findings showed a right renal tumor with suspicious of retroperitoneal bleeding. Right radical nephrectomy was performed and the pathological examination of the specimen found actinomyces colonies. The patient received 8 weeks of Penicillin after surgery and had none sequelae. easily diagnosed because of non-specific clinical and radiological findings. Early diagnosis of renal actinomycosis is important to avoid surgery since actinomyces respond well to high doses of Penicillin.