Document Type : Case reports

Authors

1 Department of Radiology, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq.

2 Department of Surgery, AL-Yarmouk Teaching Hospital, Baghdad, Iraq.

3 Department of Pediatrics, College of Medicine, Mustansiriyah University, Baghdad, Iraq.

4 Department of Obstetrics and Gynecology, College of Medicine, Mustansiriyah University, Baghdad, Iraq.

5 Advanced Body MR and Cardiothoracic Fellowship Training at UT Southwestern. The University of Texas Southwestern Medical Center: Dallas, Texas, USA.

Abstract

Renal cell carcinoma (RCC) is the most common solid lesion within the kidney and accounts for most kidney malignancies. The primary tumor size primarily determines the risk of metastasis in RCC. Literature rarely describes metastasis in tumors less than 2 cm; in fact, around 1/3 of RCC reported cases had metastatic disease at the time of diagnosis. RCC tends to metastasize to the lung in half of the patients, to the bones or the liver in 1/3 of patients, and the brain in 5% of all cases. RCC can metastasize to almost every organ in the human body. However, their metastases to the ovaries are incredibly uncommon. In this report, we describe a female presented with the smallest RCC (1cm) that metastasized to the ovary in a patient with previously undiagnosed autosomal dominant polycystic kidney disease (ADPKD). This case report aimed to raise physicians' awareness of the possibility of metastasis in RCC regardless of tumor size and that metastatic RCC could be the first presentation of patients with ADPKD.

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[1]      R. CK et al., “Metastatic Tumors to the Ovary—a Surgeon’s Dilemma,” Indian J. Surg. Oncol., vol. 12, no. 1, pp. 152–157, 2021.
[2]      J. Rysz, B. Franczyk, J. Ławiński, and A. Gluba-Brzózka, “Characteristics of clear cell papillary renal cell carcinoma (ccpRCC),” Int. J. Mol. Sci., vol. 23, no. 1, p. 151, 2021.
[3]      T. Makino, S. Kadomoto, K. Izumi, and A. Mizokami, “Epidemiology and prevention of renal cell carcinoma,” Cancers (Basel)., vol. 14, no. 16, p. 4059, 2022.
[4]      J. L. Mueller, R. A. Guyer, J. T. Adler, and J. T. Mullen, “Metastatic renal cell carcinoma to the small bowel: three cases of GI bleeding and a literature review,” CEN Case Reports, vol. 7, pp. 39–43, 2018.
[5]      J. Hołody-Zaręba, P. Kinalski, S. Sulkowski, R. Kozłowski, and M. Kinalski, “Bilateral metastases of renal cell carcinoma to the ovaries–a case report,” Ginekol. Pol., vol. 84, no. 7, 2013.
[6]      A. Takayanagi et al., “Imaging findings of ovarian metastasis of primary renal cell carcinoma: A case report and literature review,” Radiol. Case Reports, vol. 17, no. 7, pp. 2320–2327, 2022.
[7]      S. M. Monda, H. T. Lui, M. A. Pratsinis, T. Chandrasekar, C. P. Evans, and M. A. Dall’Era, “The metastatic risk of renal cell carcinoma by primary tumor size and subtype,” Eur. Urol. Open Sci., vol. 52, pp. 137–144, 2023.
[8]      M. Horta and T. M. Cunha, “Sex cord-stromal tumors of the ovary: a comprehensive review and update for radiologists,” Diagnostic Interv. Radiol., vol. 21, no. 4, p. 277, 2015.
[9]      R. A. Obeidat, A. J. Aleshawi, H. A. Obeidat, and S. M. Al Bashir, “A rare presentation of ovarian fibrothecoma in a middle age female: case report,” Int. J. Womens. Health, pp. 149–152, 2019.
[10]     W. N. M. Hassan, F. Shallal, and A. B. Roomi, “Prediction of successful Induction of labor using ultrasonic fetal parameters,” Curr. Womens. Health Rev., vol. 18, no. 1, pp. 134–139, 2022.
[11]     M. Gradzik, M. Niemczyk, M. Gołębiowski, and L. Pączek, “Diagnostic imaging of autosomal dominant polycystic kidney disease,” Polish J. Radiol., vol. 81, p. 441, 2016.
[12]     N. F. Casteleijn et al., “A stepwise approach for effective management of chronic pain in autosomal-dominant polycystic kidney disease,” Nephrol. Dial. Transplant., vol. 29, no. suppl_4, pp. iv142–iv153, 2014.
[13]     A. M. Kase, D. J. George, and S. Ramalingam, “Clear cell renal cell carcinoma: from biology to treatment,” Cancers (Basel)., vol. 15, no. 3, p. 665, 2023.
[14]     T. ŠIMUNDIĆ, J. PASINI, L. BUBIĆ FILIPI, and T. TURK, “RENAL CELL CARCINOMA IN THE AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE,” Acta medica Croat. Časopis Akad. Med. Znan. Hrvat., vol. 72, no. 4, pp. 521–524, 2018.
[15]     Y. Hakozaki, K. Uchiyama, A. Yanai, D. Yamada, Y. Kamijo, and Y. Ishibashi, “Sarcomatoid renal cell carcinoma with autosomal dominant polycystic kidney disease: a case report and literature review,” CEN Case Reports, vol. 10, pp. 199–207, 2021.
[16]     R. Alam, J. J. Tosoian, P. M. Pierorazio, and M. H. Johnson, “Distant Metastases From a Small Renal Cell Carcinoma: A Case Report,” Urol. Case Reports, vol. 4, pp. 59–60, 2016.
[17]     H. Ohnishi et al., “Metastatic renal cell carcinoma presenting as multiple pleural tumours,” Respirology, vol. 10, no. 1, pp. 128–131, 2005.
[18]     F. Uruc, S. Akan, A. Sahin, C. Yildirim, and A. Urkmez, “Contralateral ovarian metastasis of clear-cell renal carcinoma: A rare case report and review of the literature,” Case Rep. Surg., vol. 2017, 2017.
[19]     L. Liang, H. Huang, V. Dadhania, J. Zhang, M. Zhang, and J. Liu, “Renal cell carcinoma metastatic to the ovary or fallopian tube: a clinicopathological study of 9 cases,” Hum. Pathol., vol. 51, pp. 96–102, 2016.
[20]     M. Kostrzewa, M. Zyła, J. Władziński, T. Stetkiewicz, G. Stachowiak, and J. R. Wilczyński, “Metastases of renal clear cell carcinoma to ovary--case report and review of the literature,” Eur J Gynaecol Oncol, vol. 36, no. 2, pp. 219–222, 2015.
[21]     S. Bohara, B. Dey, S. Agarwal, J. N. Bharti, N. Khurana, and P. Sachdeva, “Metastatic renal cell carcinoma masquerading as a primary ovarian mass in a post-operative case of meningioma and renal cell carcinoma,” Rare Tumors, vol. 7, no. 3, pp. 111–113, 2015.
[22]     L. Toquero, O. M. Aboumarzouk, and Z. Abbasi, “Renal cell carcinoma metastasis to the ovary: a case report,” Cases J., vol. 2, pp. 1–4, 2009.
[23]     Y. Kato et al., “A case of metastatic renal cell carcinoma to the ovary,” Acta Urologica Japonica, vol. 52, no. 12, pp. 923–927, 2006.
[24]     A. Ibrahim and M. S. Al-Jafari, “Metastatic renal cell carcinoma in an ovarian benign mixed mucinous cystadenoma and brenner tumour: a case report,” Case Rep. Pathol., vol. 2012, 2012.