Brain Tumor Res Treat.  2013 Oct;1(2):99-102. 10.14791/btrt.2013.1.2.99.

Extremely Delayed Brain Metastasis from Renal Cell Carcinoma

• Choi WH
• Koh YC
• Song SW
• Roh HG
• Lim SD

• KMID: 2048483
• DOI: http://doi.org/10.14791/btrt.2013.1.2.99

Abstract

Brain metastasis occurs in 3.9-24% of patients with renal cell carcinoma (RCC), with an average interval from nephrectomy to brain metastasis of 1 to 3 years. A few cases have been reported where brain metastasis occurred after a delay of more than 10 years from the initial onset of renal cell carcinoma. This long interval for central nervous system metastasis from the primary cancer has been recognized as an indicator of better prognosis. Histopathological confirmation and aggressive treatment must be considered in these delayed brain metastases cases, since the patients usually show long survival and good prognosis. We present a case of a 76-year-old woman who developed extremely late multiple brain metastases 18 years after a nephrectomy for RCC.

Keyword

Renal cell carcinoma; Brain metastasis; Recurrence

MeSH Terms

Aged
Brain*
Carcinoma, Renal Cell*
Central Nervous System
Female
Humans
Neoplasm Metastasis*
Nephrectomy
Prognosis
Recurrence

Figure

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  Fig. 1 Series of patient's brain MRI showing the metastatic tumors in different locations. A: Initial sagittal gadolinium-enhanced brain MR image (Dec. 2005) showing a well enhanced large epidural tumor compressing the superior sagittal sinus, with a small tentorial meningioma and another well enhanced 4th ventricle floor mass. B: Axial gadolinium-enhanced brain MR image (Jan. 2008) showing a doubling of the 4th ventricular tumor and increased peritumoral edema. C: Post-operative axial gadolinium-enhanced brain MR image showing gross total resection of the periventricular tumor. D: Follow-up brain MR image (May 2009) showing recurrence of the resected vertex mass.

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  Fig. 2 Clear cell renal cell carcinoma showing solid nests of clear cells separated by a prominent delicate vascular network. These findings were compatible with renal cell carcinoma.

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