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2005, Number 6

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Gac Med Mex 2005; 141 (6)

Uncommon metastases in renal carcinoma.

Arroyo C, Palacios P, Uribe N, Barrera M, Feria G

Language: Spanish
References: 42
Page: 545-550
PDF size: 71.70 Kb.


ABSTRACT

Introduction: Renal clear cell carcinoma (RCCCa) represents 2-3% of the neoplasms in the adult population, and can be metastastatic in up to 30% at the time of diagnosis. In these cases its mortality can be of up to 99% in 5 years, due to the lack of response to current treatments, unless it is a single, surgically resectable metastasis. Currently, there is no explanation for its routes of progression, it even seems to be non existent based on the rare tumor implant sites.
Objective: To report unusual metastasis from RCCCa and a review of the literature.
Material and methods: We reviewed retrospectively 15 years of patient records diagnosed with metastasic CaRCC different from: local lymph nodes, lung, bone or liver. We identified 11 cases: brain (2), duodenum (2), tonsils, thyroid, esophagus, diaphragm, testicle, adrenal gland and soft tissue of the knee.
Conclusion: A description of this and other literature series with rare metastasis was done, as well as an analysis of possible routes and mechanisms responsible for the unusual tumor progression in RCCCa. We need to continue investigating the dissemination pathways and other cellular conditions involved in metastastatic kidney cancer in order to better understand and improve the treatment of patients in advanced stages.


REFERENCES

  1. Hock L, Lynch J, Balaji K. Increasing incidence of all stages of kidney cancer in the last 2 decades in the United Statues: an analysis of surveillance, epidemiology and end results program data. J Urol 2002;167:57-60.

  2. 2. Registro Histopatológico de Neoplasias Malignas, México 2001, CD (c)2004. www.dgepi.salud.gob.mx

  3. 3. Liu S, Semenciw R, Morrison H, Schanzer D, Mao Y. Kidney Cancer in Canada: The Rapidly Increasing Incidence of Adenocarcinoma in Adults and Seniors. J Urol 1998;160(2):634.

  4. 4. Tigrani VS, Reese DM, Small EJ, Presti JC Jr, Carroll PR. Potential role of nephrectomy in the treatment of metastatic renal cell carcinoma: a retrospective analysis. Urology 2000;56(1)36-40.

  5. 5. Motzer RJ, Bacik J, Mariani T, Russo P, Mazumdar M, Reuter V. Treatment outcome and survival associated with metastatic renal cell carcinoma of non-clear-cell histology. J Clin Oncol 2002;20(9):2376-2381.

  6. 6. Kollender Y, Bickels J, Price WM, Kellar KL, Chen J, Merimski O, Meller I. Metastatic renal cell carcinoma of bone: indications and technique of surgical intervention. J Urol 2000;164(5):1505-1508.

  7. 7. Piltz S, Meimarakis G, Wichmann MW, Hatz R, Schilberg FW, Fuerst H. Long-term results after pulmonary resection of renal cell carcinoma metastases. Ann Thorac Surg 2002;73(4):1082-1087.

  8. 8. Zisman A, Wieder JA, Pantuck AJ, Chao DH, Dorey F, Said JW, et al. Renal cell carcinoma with tumor thrombus extension: biology, role of nephrectomy and response to immunotherapy. J Urol 2003;169(3);909-916.

  9. 9. Milowsky MI, Nanus DM. Chemotherapeutic strategies for renal cell carcinoma. 2003;30(3);601-610.

  10. Camassei FD, Arancia G, Cianfriglia M, Bosman C, Francalanci P, Rava L et al. Nephroblastoma: multidrug-resistance P-glycoprotein expression in tumor cells and intratumoral capillary endotelial cells. Am J Clin Pathol 2002;117(3);484-490.

  11. Zang Q, Chen Z, Shi Z. Mechanisms of drug resistance of primary renal cell carcinomas and their clinical significance. Zhonghua Zhong Liu Za Zhi 2000;22(2);145-147.

  12. Heuser M, Herrmann R, Zoeller G, Hemmerlein B. Dynamic assessment of angiogenesis in renal cell carcinoma spheroids by intravital microscopy. J Urol 2003:169:1267-1270.

  13. Bukowski RM. Natural history and therapy of metastatic renal cell carcinoma: The role of Interleukin-2. Cancer 1997;80;1198-1220.

  14. Kallmeyer J, Kalmeyer I. Spontaneous regression of metastases in a case of bilateral renal cell carcinoma. J Urol 1995;153:75.

  15. Ringhoffer M, Muller CR, Schenk A, Kirsche H, Schmitt M, Greiner J, et al. Simultaneous expression of T-cell activating antigens in renal cell carcinoma: implications for specific immunotherapy. J Urol 2004;171(6):2456-2460.

  16. Schwaab T, Schned AR, Heaney JA, Cole BF, Atzpodien J, Wittke F, et al. In vivo description of dendritic cells in human renal cell carcinoma. J Urol 1999;162(2):567-573.

  17. Arroyo JC, Gabilondo F, Llorente L, Meraz-Rios MA, Sanchez-Torres C. Immune response induced in vitro by CD16- and CD16+ monocyte-derived dendritic cells in patients with metastatic renal cell carcinoma treated with dendritic cell vaccines. J Clin Immunol 2004;24(1);86-96.

  18. Rini BI, Stadler WM, Spilberger RT, Ratain MJ, Vogelzang NJ, et al. Granulocyte-Macrophage-Colony stimulating factor in metastatic renal cell carcinoma. A phase II trial. Cancer 1998;82(7):1352-1358.

  19. Gez E, Rubinou R, Gaitini D, Meretyk S, Best LA, Native O, et al. Interleukin-2, Interferon a, 5-Flourouracil and vinblastine in the treatment of metastatic renal cell carcinoma. Cancer 2002;95(8):1644-1649.

  20. Schwaab T, Heaney JA, Schned AR, Harris RD, Cole BF, Noelle RJ, et al. A randomized phase II trial comparing two different sequence combinations of autologous vaccine and human recombinant interferon g and human recombinant interferon a 2B therapy in patients with metastatic renal cell carcinoma: clinical outcome and analysis of immunological parameters. J Urol 2000;163(4):1322-1327.

  21. Verra N, Jansen R, Groenewegen G, Mallo H, Kersten MJ, Bex A. et al. Immunotherapy with concurrent subcutaneous GM-CSF, low dose IL-2 and IFN-alfa in patients with progressive metastatic renal cell carcinoma. Br J Cancer 2003;88(9):1346-1351.

  22. Krishnamurti V, Novick AC, Bukowski R. Nephron sparing surgery in patients with metastatic renal cell carcinoma. J Urol 1996;156(1);36-39.

  23. Wood CG. The role of cytoreductive nephrectomy in the management of metastatic renal cell carcinoma. Urol Clin N Am 2003;30(3);581-588.´

  24. Sheehan J, Perry IJ, Reilly M, Salim A, Collins M, Twomey EM, et al. Radiosurgery in patients with renal cell carcinoma metastasis to the brain; long-term outcomes and prognostic factors influencing survival and local tumor control. J Neurosurg 2003;98(2):342-349.

  25. Uemura T, Kurita A, Nishimura R, Ishizaki M, Takashima S. Solitary pancreatic metastasis from renal cell carcinoma concomitant with early gastric cancer 17 years alter nephrectomy: report of a case. Surg Today 2003;33(5):395-398.

  26. Schatteman P, Willemsen P, Vanderveken M, Lockefeer F, Vandebroek A. Skeletal muscle metastasis from a convencional renal cell carcinoma, two years after nephrectomy: a case report. Acta Chir Belg 2002;102(5):351-352.

  27. Moudouni S, En-Nia I, Rioux-Leclerc N, Patard JJ, Guille F, Lobel B. Renal metastasis of thyroid carcinoma. Prog Urol 2001;11(4):670-672.

  28. Hammad AM, Paris GR, van Heuven WA, Thompson IM, Fitzsimmons TD. Spontaneous regression of choroidal metastasis from renal cell carcinoma. Am J Ophthalmol 2003;135(6):911-913.

  29. Cheng A. Cardiac metastasis from a renal cell carcinoma. Int J Clin Pract 2003;57(5):437-438.

  30. Nozawa H, Tsuchiya M, Kobayashi T, Morita H, et al. Small intestinal metastasis from renal cell carcinoma exhibiting rare findings. Int J Clin Pract 2003;57(4):329-331.

  31. Limani K, Matos C, Hut F, Galin M, Closset J. Metastatic carcinoma of the gallbladder after a renal cell carcinoma. Acta Chir Belg 2003;103(2):233-234.

  32. Pilecki S. Metastasis of renal carcinoma to the diaphragm. Wiad Lek 2002;55(1-2):120-124,.

  33. Paul R, Mordhorst J, Leyh H, Hartung R. Incidence and outcome of patients with adrenal metastases of renal cell cancer. Urology 2001;57:878-882.

  34. Herrera-Puerto J, Herrera-Flores J, Lopez-Elzaurdia C, Cermeno-Giles F. Pierna-Manzano J, Isusquiza-Garro I, et al. Penile metastasis of renal cell carcinoma. Actas Urol Esp 2002;26(8):589-591.

  35. Moudouni SM, En-Nia I, Rioux-Leclerc N, Manunta A, Guille F, Lobel B. Prostatic metastases of renal cell carcinoma. J Urol 2001;165(1):190-191.

  36. Fusetti C, Kurzen D, Bonaccio M, Buchler U, Nagy L. Hand metastasis in renal cell carcinoma. Urology 2003;62:141.

  37. Damron T, Heiner J. Management of metastatic disease to soft tissue. Orthop Clin N Am 2000;31(4); 661-673.

  38. Gettman M, Boelter C, Cheville J, y cols. Charlson co-morbidity index as a predictor of outcome after surgery for renal cell carcinoma with renal vein , caval vein or right atrium extention. J Urol 2003;169:1282-1286.

  39. Zisman A, Pantuck AJ, Wieder J, Chao DH, Dorey F, Said JW, deKrnion JB, Figlin RA, Belldegrun AS. Risk group assessment and clinical outcome algorithm to predict the natural history of patients with surgically resected renal cell carcinoma. J Clin Oncol 2002;20(23):4559-4566.

  40. Ambrosiani L. Thyroid metastases from renal clear cell carcinoma: a cyto-histological study of two cases. Adv Clin Path 2001;5(1-2):11-16.

  41. Weigensberg I. The man faces of metastatic renal carcinoma. Radiology 1971;98;353-358.

  42. Gill IS, Schweizer D, Hobart MG, Sung GT, Klein EA, Novick AC. Retroperitoneal laparoscopic radical nephrectomy: the Cleveland clinic experience. J Urol 2000;163(6):1665-1670.




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