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Metastatic Tumors

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Definition
Tumors of extrarenal origin that secondarily involve the kidney.

Clinical Features

Renal involvement: o part of a disseminated process o rarely of clinical significance1,2 o may appear years or decades after removal of the primary tumor3 Microscopic hematuria in 31%4

Gross Pathology

Commonest primary sites: o lung o skin (malignant melanoma) o breast o gastrointestinal tract o pancreas o ovary o testis5,6

Histopathology

Sometimes limited to the renal glomeruli in an intracapillary or extracapillary fashion7,8

Diagnosis

If limited to the renal glomeruli may be diagnosed by needle biopsy7,8

Other Investigations

CT scan: o renal metastases tend to be: small multiple bilateral wedge shaped intracortical less exophytic than primary renal cell carcinoma9

Differential Diagnosis
Select up to 2 differential diagnoses to compare with Metastatic Tumors Renal Cell Carcinoma (Conventional Type) (View full diagnosis) Renal Sarcomas (View full diagnosis)

Renal cell carcinoma

In contrast to renal cell carcinoma, bilateral in >50% of cases4

Primary renal tumor

Metastatic tumors to the kidney simulating primary renal tumors: o SETTLE o adenoid cystic carcinoma of breast10 o the follicular variant of papillary thyroid carcinoma11

References

1 Davis RI, Corson JM. Renal metastases from well-differentiated follicular thyroid carcinoma. A case report with light and electron microscopic findings. Cancer. 1979;43:265268. 2 Herzberg AJ, Bossen EH, Walther PJ. Adenoid cystic carcinoma of the breast metastatic to the kidney. A clinically symptomatic lesion requiring surgical management. Cancer. 1991;68:10151020. 3 Johnson MW, Morettin LB, Sarles HE, Zaharopoulos P. Follicular carcinoma of the thyroid metastatic to the kidney 37 years after resection of the primary tumor. J Urol. 1982;127:114116. 4 Wagle DG, Moore RH, Murphy GP. Secondary carcinomas of the kidney. J Urol. 1975;114:3032. 5 Bates AW, Baithun SI. The significance of secondary neoplasms of the urinary and male genital tract. Virchows Arch. 2002;440:640647. 6 Tamboli P, Abrahams NA, Wright ET, Ro JY, Ayala AG. Metastases to the kidney: a clinicopathologic analysis of 50 cases (Abstract). Mod Pathol. 2003;16:172a. 7 Belghiti D, Hirbec G, Bernaudin JF, Pariente EA, Martin N. Intraglomerular metastases. Report of two cases. Cancer. 1984;54:23092312. 8 Toth T. Extracapillary tumorous metastatic crescents in glomeruli of the kidney. Pathol Res Pract. 1987;182:240243. 9 Honda H, Coffman CE, Berbaum KS, Barloon TJ, Masuda K. CT analysis of metastatic neoplasms of the kidney. Comparison with primary renal cell carcinoma. Acta Radiol. 1992;33:3944. 10 Colome MI, Ro JY, Ayala AG, El-Naggar AK, Siddiqui RT, Ordonez NG. Adenoid cystic carcinoma of the breast metastatic to the kidney: an unusual site of initial distant metastasis, mimicking a primary renal tumor. J Urol Pathol. 1996;4:6978. 11 Gamboa-Dominguez A, Tenorio-Villalvazo A. Metastatic follicular variant of papillary thyroid carcinoma manifested as a renal neoplasm. Endocr Pathol. 1999;10:265268. Last updated: 1 Mar 2006

Metastatic Tumors
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Definition

Clinical Features Gross Pathology Histopathology Diagnosis Other Investigations Differential Diagnosis References

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