Iris metastasis from clear cell renal cell carcinoma: A case report

Abstract

Background: Clear cell renal cell carcinoma (ccRCC) is a common type of tumor that can metastasize to any organs and sites. However, it is extremely rare for ccRCC to metastasize to the iris. Here, we describe a rare case of iris metastasis from ccRCC with a history of left nephrectomy in 2010.

Case summary: A 62-year-old male was admitted to the hospital due to blurred vision and red eyes, and a mass was found on the iris in the right eye. B-scan ultrasonography revealed a well-bounded high-density lesion at the corner of the anterior chamber at the 3-4 o'clock position. Phacoemulsification with simultaneous intraocular lens implantation and iridocyclectomy was performed in the right eye. The lesion was confirmed to be metastatic ccRCC by histological and immunohistochemical analyses. The patient was still alive at 9 mo after surgical treatment. Ocular metastasis can be an initial sign with a poor prognosis. Timely detection and treatment may improve survival. Clinicians should pay attention to similar metastatic diseases to prevent misdiagnosis leading to missed treatment opportunities.

Conclusion: This report of the characteristics and successful management of a rare case of iris metastasis from ccRCC highlights the importance of a comprehensive medical history, histopathology, immunohistochemistry, and clinical manifestation for successful disease diagnosis.

Keywords: Case report; Clear cell renal cell carcinoma; Diagnosis; Iris metastasis; Literature review; Prognosis.

Figure 1

Eye ultrasound image. A well-bounded, high-density lesion was observed at the corner of the anterior chamber at the 3 o’clock position.

Figure 2

Hematoxylin and eosin staining and immunohistochemical staining of the Iris mass. A: Normal iris tissue was observed around the tumor (100 ×); B: The tumor cells were large, cube-shaped, and in a solid nest-like arrangement and the nuclei were round or ovate with visible nucleoli (400 ×); C-E: The tumor cells were immunoreactive for cytokeratin pan (200 ×) (C), paired box gene 8 (200 ×) (D), and cluster of differentiation 10 (200 ×) (E).