CASE 16365 Published on 14.05.2019

Renal metastasis from oesophageal squamous cell carcinoma

Section

Uroradiology & genital male imaging, Hybrid imaging

Case Type

Clinical Cases

Authors

Weifang Zhang, Annan Zhang; Department of nuclear medicine, Peking University Third Hospital, Beijing, The People's Republic of China

Patient

64 years

Categories
Area of Interest Abdomen, Kidney, Molecular imaging, Nuclear medicine ; Technique CT, PET-CT
Discussion

In the present case, an extensive infiltrating tumour involving the right kidney and the retroperitoneum raised the diagnosis of a primary undifferentiated urothelial cancer, lymphoma or metastatic disease. The patient was known with a history of oesophageal cancer, and although rare, the renal metastasis was considered in the differential diagnosis.

Solitary metastasis to the kidney from oesophageal cancer is extremely rare. So far, the present and the previously reported 17 cases are summarised in table 1 (Fig. 6) [1-4]. However, according to autopsy reports it is not uncommon to detect renal metastases from oesophageal cancer. Indeed, the proportion of renal metastases from oesophageal cancer is nearly 13% [5]. An explanation for the low number of clinical reports is that the majority of patients remain free of symptoms, few patients only have manifestations of haematuria and proteinuria. All cases of metastatic renal tumour are male patients and the vast majority of the cases are from Asia, especially China, Japan, and South Korea.

Only one case showed renal metastasis of oesophageal adenocarcinoma, while all the other cases were renal metastasis of squamous carcinoma. The interval between metastasis and primary tumor is 2 to 36 months and the survival time with renal metastasis is even more widely variable. The survival time after detection of renal metastasis of oesophageal squamous cell carcinoma is generally less than 6 months and only few patients will ultimately survive more than 2 years. The survival time of renal metastasis from esophageal adenocarcinoma in the single case reported exceeded 9 years. 

Immunohistochemical markers contribute to the differentiation of primary urothelial cancer from the metastatic squamous cell carcinoma. Also, the markers of CK7/CK20/uroplakin III-negative are likely supporting the diagnosis of the metastatic squamous cell carcinoma [1]. Therefore, the possibilities of renal metastasis should be considered for newly developed solid renal mass lesions in patients with oesophageal cancer.

Written informed patient consent for publication has been obtained.

Differential Diagnosis List
Primary renal cancer
Renal lymphoma
Infiltrating renal metastasis of the oesophageal squamous cell carcinoma
Renal sarcoma
Renal Ewing's sarcoma
Final Diagnosis
Infiltrating renal metastasis of the oesophageal squamous cell carcinoma
Case information
URL: https://www.eurorad.org/case/16365
ISSN: 1563-4086