Korean J Urol.  2006 Jun;47(6):670-673. 10.4111/kju.2006.47.6.670.

Solitary Metastatic Renal Tumor from Breast Cancer

• Joo JS
• Im CM
• Lee JS
• Oh KJ
• Kang TW
• Kwon DD
• Park K
• Ryu SB

• KMID: 2294246
• DOI: http://doi.org/10.4111/kju.2006.47.6.670

Abstract

We report a case of a metastatic renal tumor secondary to breast cancer 9 years postmastectomy. This is the first case report of solitary renal metastasis from breast cancer with no other evidence of metastasis. A 47-year-old woman underwent a modified radical mastectomy and 6 cycles of CEF chemotherapy (Cyclophosphamide, Epirubicin, 5-FU) for cancer of the left breast. She was followed closely, but no recurrence or metastases were detected on either a physical or radiological examination. 9 years later, on a routine follow-up examination for metastatic breast cancer, abdomen ultrasound revealed a solid mass (4cm in diameter) in the upper portion of the right kidney. Computed tomography (CT) was used to further evaluate the solitary renal mass, which had become moderately enhanced. No regional lymph node, visceral or pulmonary metastases were found. A radionuclide bone scan confirmed no bony involvement. A laparoscopic radical nephrectomy was performed for a right renal tumor. The histopathological features were identical to those for cancer of the right breast. The patient was treated with adjuvant combination chemotherapy (docetaxel and adriamycin), and is still alive 9 months after a right radical nephrectomy, with no evidence of recurrence.

Keyword

Kidney neoplasms; Breast cancer; Neoplasm metastasis

MeSH Terms

Abdomen
Breast Neoplasms*
Breast*
Drug Therapy
Drug Therapy, Combination
Epirubicin
Female
Follow-Up Studies
Humans
Kidney
Kidney Neoplasms
Lymph Nodes
Mastectomy, Modified Radical
Middle Aged
Neoplasm Metastasis
Nephrectomy
Recurrence
Ultrasonography
Epirubicin

Figure

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  Fig. 1 Whole body bone scan showing no bony metastasis. High uptake of the L5-S1 lesion, suggestive of a degenerative joint disease.

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  Fig. 2 Ultrasonogram demonstrating a 4cm bulging solid mass in the upper pole of the right kidney.

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  Fig. 3 Computed tomography (CT) scan demonstrating a heterogeneous enhanced mass in the upper portion of the right kidney.

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  Fig. 4 Gross findings of the renal mass, revealing a yellow to brown colored, encapsulated mass, with a focal hemorrhage.

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  Fig. 5 Histological evaluation of the renal mass demonstrating proliferated tumor cells. A striking similarity in the histological pattern to that observed in the originally removed breast malignancy is observed. H&E ×200, CD10 (-), estrogen receptor (+), progesterone receptor (+).

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