Renal cell carcinoma metastasis to the ovary: a case report

Abstract

A 54-year-old woman referred to a specialist unit for weight loss, lethargy, and a palpable pelvic mass. Thought to have ovarian cancer metastasized to the kidney, underwent a left nephrectomy and para-aortic clearance, with a total abdominal hysterectomy and bilateral salpingo-oophorectomy with peritoneal biopsies. Histology proved it was actually a renal cell carcinoma metastasized to the ovaries. During further follow ups she had developed bone and pulmonary metastasis and died shortly after the diagnosis of metastasis. With only 14 reported cases in the literature increased awareness would aid management of similar cases.

Figure 1.

Contrast CT scan of the Left Renal Cell Carcinoma revealing a 10 × 8 cm intensely enhancing heterogeneous mass arising from the upper pole.

Figure 2.

Contrast CT scan of the Left Ovarian metastasis; showing a 4 cm heterogeneous mass with fairly intense enhancement.

Figure 3.

Haematoxylin & Eosin stained section of kidney tumour. Some parts are low grade clear cell (inset top right), but most (main photo) is high grade with eosinophilic cytoplasm, as were the metastases. Scale is 50 mu; low grade and high grade transformation with sarcomatoid features.

Figure 4.

Haematoxylin & Eosin stained section from ovarian metastasis. Same pattern as high grade parts of kidney. Note typical thin walled staghorn vessels, the large one containing strands of fibrin; entirely consistent with metastatic high grade renal cell carcinoma.