PICTURES IN DIGESTIVE PATHOLOGY

 

Nodular colonic lesion in a nephrectomized patient

Lesión nodular colónica en paciente con nefrectomía

 

 

Luis Ignacio Fernández-Salazar¹, Diego Soto de Prado-Otero², Benito Velayos-Jiménez¹ and José Manuel González-Hernández

Departments of ¹Gastroenterology, and ²Oncology. Hospital Clínico Universitario. Valladolid, Spain

 

 

Case report

A 54 years old man casually diagnosed with right renal hypernephroma underwent a radical right nephrectomy seven years ago. The pathologic exam confirmed a clear cell carcinoma. In the follow up study, an abdominal CT demonstrated metastasis shaped lesions in liver and left kidney and a hypervascular colonic nodular lesion (Fig. 1). A colonoscopy was performed. The pathologic study of the colonic biopsies confirmed the presence of a clear cell carcinoma metastasis (immunohistochemistry was positive for cytokeratin AE1, AE3, vimentin, and focally CD10). Extension study was completed. Surgical treatment was not indicated and for an indefinite period of time sunitinib treatment was initiated.

 

Discussion

Colonic metastasis of renal tumours is uncommon in medical literature. Descriptions deal with clear cell tumours (1), mixed granular and clear cells tumors (2) and sarcomatoid tumors (3). Differential diagnosis includes the also infrequent double kidney and colon cancer (4). Gastric and duodenum metastasis have also been described (5).

 

References

1. Valdespino-Castillo VE, Ruiz-Jaime A. Renal cell carcinoma with colon metastases: an infrequent site for metastases. Cir Cir 2008;76 (4):339-42.         [ Links ]

2. Lee JG, Kim JS, Kim HJ, Kim ST, Yeon JE, Byun KS, et al. Simultaneous duodenal and colon masses as late presentation of metastatic renal cell carcinoma. Korean J Intern Med 2002;17(2):143-6.         [ Links ]

3. Invernizzi R, Bencardino K, Porta C, Vercelli A, Viglio A, Manzoni M, et al. Sigmoid colon metastasis from sarcomatoid renal cell carcinoma. Tumori 2006;92(3):246-8.         [ Links ]

4. D'Amato A, Gentili V, Santella S, Pronio A, Montesani C. Synchronous neoplasms of the colon and kidney: analysis of 2 case reports. Chir Ital 2000;52(1):83-6.         [ Links ]

5. Haffner J, Morel JF, Maunoury V, Caty A, Biserte J, Villers A. Gastric or duodenal metastases from clear cell renal cell carcinoma. Report of two cases and review of the literature. Prog Urol 2007;17(7):1305-9.         [ Links ]