Pulmonary Metastasis from Renal Cell Carcinoma 21 Years after Nephrectomy

Abstract

This research reports a case of pulmonary metastasis from renal cell carcinoma with a disease free interval of 21-years.  The patient at 44-years old underwent a left nephrectomy for clear cell cancer from renal cell carcinoma.  The patient who visited an outpatient clinic in our hospital due to hypnagogic pollakiuria was diagnosed of benign prostate hyperplasia and the neurologic bladder, and received medication till 61-years-old.  The patient was thereafter diagnosed of degeneration of cerebral basal ganglions in another hospital and was suspected to have prostate cancer, hence systemic examination and transrectal prostate biopsy was performed.  Computed tomography (CT) revealed a well-defined, homogeneous nodular shadow, 6.6 mm in size, at the right lower lobe.  From the CT, the nodule had become enlarged to a maximal diameter 7.9 mm at age 65-years-old.  Surgical biopsy was performed from 8 cm surgical wounds using a thoracoscope.  The tumor was palpable and then resected by staplers, and were well defined and yellowish in color.  The pathological examination revealed that almost all the tumor cell were clear cell cancer from renal cell carcinoma.  A few cases of recurrent renal cell carcinoma after a long interval from initial diagnosis have been seen.