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Case Reports
. 2019 Sep 24:2019:7480479.
doi: 10.1155/2019/7480479. eCollection 2019.

Isolated Splenic Metastases from Renal Cell Carcinoma 11 Years after Surgery

Davi Dos Santos Romao  1 , Natally Horvat  1 , Marianne Castro Gonçalves  2 , Emerson Shigueaki Abe  3 , Rodrigo Blanco Dumarco  3 , Publio Cesar Cavalcante Viana  1 , Marcel Cerqueira Cesar Machado  3
Affiliations
Case Reports

Isolated Splenic Metastases from Renal Cell Carcinoma 11 Years after Surgery

Davi Dos Santos Romao et al. Case Rep Med. .

Abstract

Splenic metastases are rare and usually occur in cases of disseminated disease. We report a case of a patient who had isolated splenic metastases with a previous history of left nephrectomy due to a renal cell carcinoma 11 years before. The aim of this report is to describe the case and review the literature of isolated splenic metastases due to renal carcinoma. This case emphasizes the importance of considering splenic metastatic disease even after many years of diagnosis of renal cell carcinoma.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Contrast-enhanced MRI of the abdomen on initial staging of the renal tumor. (a) Coronal T1-weighted image and (b) axial T2-weighted image demonstrated a left renal mass in the upper pole of the left kidney with cystic areas (arrows).
Figure 2
Figure 2
Contrast-enhanced CT of the abdomen 11 years after the left nephrectomy. (a) Coronal and (b) axial images showed two solid-cystic splenic masses (arrows) with heterogeneous enhancement, infiltrating the diaphragm (arrowhead).
Figure 3
Figure 3
Contrast-enhanced MRI of the abdomen 11 years after the left nephrectomy. (a) Axial T2-weighted image and (b) axial postcontrast T1-weighted image depicted two solid-cystic splenic masses (arrows), infiltrating the diaphragm (arrowhead).
Figure 4
Figure 4
Positron emission computed tomography (PET/CT) scan of the whole body showed two splenic masses (arrows) indistinct on CT without intravenous contrast (a), with increased FDG uptake (SUV 9,0) (b), and without other suspicious lesions (c).
Figure 5
Figure 5
Surgical specimen of splenectomy demonstrated two lobulated yellowish lesions within the spleen (a, b). A portion of the left diaphragm was also resected due to the adhesion process (c, arrowhead).
Figure 6
Figure 6
Detail of the neoplasm, composed of nests and solid sheets of cells with abundant and clear cytoplasm. The nuclei are enlarged with some conspicuous nucleoli (H&E 200x).
Figure 7
Figure 7
The neoplastic cells expressed CK8/18 (a), CD10 (b), PAX8 (c), and vimentin (d), being consistent with metastasis of clear cell renal carcinoma.
See this image and copyright information in PMC

References

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