Small (<4 cm), Unclassified Renal Cell Carcinoma Presenting with Initial Bone Metastasis: A Case of a Metastatic Lesion Missed at the Initial Diagnosis
이승제, 황의창, 황인상, 유호송, 김선옥, 정승일, 강택원, 권동득, 심현정, 최찬,
소속 상세정보
이승제 ( Lee Seung-Je )
Chonnam National University Medical School Department of Urology
황의창 ( Hwang Eu-Chang )
Chonnam National University Medical School Department of Urology
황인상 ( Hwang In-Sang )
Chonnam National University Medical School Department of Urology
유호송 ( Yu Ho-Song )
Chonnam National University Medical School Department of Urology
김선옥 ( Kim Sun-Ouck )
Chonnam National University Medical School Department of Urology
정승일 ( Jung Seung-Il )
Chonnam National University Medical School Department of Urology
강택원 ( Kang Taek-Won )
Chonnam National University Medical School Department of Urology
권동득 ( Kwon Dong-Deuk )
Chonnam National University Medical School Department of Urology
심현정 ( Shim Hyun-Jeong )
Chonnam National University Medical School Department of Hematology-Oncology
최찬 ( Choi Chan )
Chonnam National University Medical School Department of Pathology
KMID : 0358320120530120883
Abstract
A 49-year-old man presented with an incidentally detected right renal mass on a health examination. The abdominal computed tomography and magnetic resonance imaging showed a 3-cm right renal mass suspected of being a hypovascular tumor, such as papillary renal cell carcinoma, and an osteoblastic metastatic lesion on the right iliac bone. However, we missed a bone lesion at the time of diagnosis. A laparoscopic radical nephrectomy was performed and the final pathology confirmed unclassified renal cell carcinoma. The follow-up imaging studies showed several neck lymph nodes and multiple bone metastases at the lumbar spine, right iliac bone, and left femur. Thirteen cycles of temsirolimus were administered to the patient, but follow-up positron emission tomography showed newly developed liver and left adrenal metastasis and increased bone metastasis. It is important to note that T1a renal cell carcinoma can present with distant metastasis and thus demands scrupulous examination even though the tumor size may be small.
키워드
Neoplasm metastasis; Neoplasms by histologic type; Renal cell carcinoma; Temsirolimus
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