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. 2020 Jan-Mar;46(1):80-89.
doi: 10.12865/CHSJ.46.01.11. Epub 2020 Mar 31.

Metastases to the Kidney: A Case Report and Review of the Literature

Sergiu Marian Cazacu  1 , Larisa Daniela SĂndulescu  1 , George Mitroi  2 , Daniela Carmen Neagoe  1 , Costin Streba  3 , Dana Maria Albulescu  4
Affiliations

Metastases to the Kidney: A Case Report and Review of the Literature

Sergiu Marian Cazacu et al. Curr Health Sci J. 2020 Jan-Mar.

Abstract

Renal metastases are uncommon in clinical practice, even as autopsy reports much frequent cases în disseminated tumors. Usually multiple and bilateral, they can determine many problems of differential diagnosis in case of solitary renal mass, when a primary kidney neoplasm must be excluded. Main sources are represented by the tumors of the lung, breast, digestive tract, melanomas and lymphomas, but rare cases with other etiology have been reported. Imaging can help to the diagnosis; CT scan, MRI, transabdominal ultrasound and sometimes contrast enhanced ultrasound can be useful. The treatment is individualized by the general status, by other organs involved and by the control of primary tumors; nephrectomy can be made in cases with unsure diagnosis and if primary tumor is controlled.

Keywords: contrast enhanced ultrasound; lung tumor; renal carcinoma; renal metastases.

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Figures

Figure 1
Figure 1
Ultrasound detected multiple hypoechogenic, round shaped, inhomogeneous renal mass (white arrow)
Figure 2
Figure 2
Grey scale sonography demonstrates multiple oval shaped, hypoechogenic and inhomogeneous lesions in the spleen (spleen metastases)
Figure 3
Figure 3
On CEUS scan in the corticomedullary phase, the renal lesion presents a slightly inhomogeneous enhancement with several necrotic areas. b. In venous phase, the lesion reveals no enhancement
Figure 4
Figure 4
CEUS shows hypoenhancement of the lesion during the arterial phase. b. Asecond lesion can be seen in the parenchymal phase; both masses demonstrate washout appearance
Figure 5
Figure 5
CT after contrast: mediastino-pulmonary mass (blue arrow), esophageal dilation (green arrow), osteolysis of vertebral body T5
Figure 6
Figure 6
CT after contrast: hypoenhanced metastasis of adrenal glands (red arrow), kidney (blue arrow), lymph nodes (green arrow), osteolysis L1 (dark arrow)
Figure 7
Figure 7
Reconstruction CT 3D in coronal plane, after contrast-heterogenous mediastino-pulmonary mass, with encasement of middle and posterior mediastinum, with important mass effect to esophagus (much enlarged); hypoenhanced metastases located to the spleen adrenal glands and both kidneys
Figure 8
Figure 8
CT after contrast: bilateral, hypoenhanced metastasis of kidney (dark arrow)
See this image and copyright information in PMC

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