Case Report

Metastatic Clear Cell Renal Cell Carcinoma: A Mimicker of Primary Clear Cell Carcinoma Ovary: How to Differentiate?

Monisha Choudhury, Deepti Verma, Alka Mittal, Shveta Wadhwa and Shaji Thomas
World Journal of Pathology 2014, 3:13

Abstract

Introduction

Renal cell carcinomas account for about 3/ 4th of the renal tumors. About 1 /3rd of these have metastatic disease. However, metastasis to ovaries is rare. Only few cases have been reported in literature. We are reporting a case of 45 year old lady presenting with simultaneous clear cell renal cell carcinoma along with ovarian metastasis.

Case presentation

A 45 year old lady presented with complaints of hematuria for 7 months. A diffuse lump was noticed in the right lumbar region and iliac fossa measuring 10 X 8 cm in size. CECT of abdomen showed a heterogeneously enhancing lesion measuring 9.9 X 8.4 X 8.2 cm in upper and midpole of right kidney suggestive of oncocytoma or renal cell carcinoma (RCC) and a heterogeneously enhancing right adnexal lesion likely to be of malignant etiology. However, serum CA-125 level was within normal limits. The right sided radical nephrectomy was performed along with total abdominal hysterectomy with bilateral salpingoophrectomy. A diagnosis of right sided renal cell carcinoma with metastasis to right ovary was established on histopathological and immunohistochemical examination.

Conclusion

The metastatic clear cell RCC should be considered as a differential diagnosis of clear cell tumors in ovary. The distinction is important for their therapeutic and prognostic implications. This is possible on the basis of their histomorphological and immunohistochemical characteristics.

Keywords

renal cell carcinoma, clear cell carcinoma, ovarian metastasis

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