[Solitary metastasis of a clear cell renal cell carcinoma after a 20 year latency clinically simulating a vascular tumor].
METHODS
A 72-year-old woman was referred because of progressive skin discoloration with venectasia and swelling in the left lower leg, the possible diagnosis being atypical varicose veins. 20 years before she had a right nephrectomy for "clear-cell" renal adenocarcinoma with subsequent tele-cobalt radiotherapy. On examination a pulsating swelling was palpated over the hyperpigmented area of the skin with venectasia.


METHODS
She had hypercholesterolaemia (254 mg/dl) and hyperuricaemia (uric acid 6.2 mg/dl). Duplex sonography, angiography and computed tomography of the lower leg revealed a vascular tumour with infiltration of the right head of the gastrocnemius.


METHODS
Because an arteriovenous fistula within a vascular soft-tissue tumour of unknown histology was suspected, a wide resection was performed. Histopathological examination revealed a metastasis of a clear-cell adenocarcinoma. Postoperative diagnostic tests discovered no other findings suspicious of malignancy. It is therefore to be assumed that the resected tumour was a solitary metastasis of the renal adenocarcinoma removed 20 years previously.


CONCLUSIONS
Even rare causes should be considered in the differential diagnosis of vascular tumour, as this case of a solitary metastasis after a latency of 20 years demonstrates.
Rothfuss-Kikillus
X
X
Abteilung für Gefässchirurgie, St. Franziskus-Hospital Münster.
Torsello
G
G
Kasprzak
B
B
Edel
G
G
D018262:Adenocarcinoma, Clear Cell / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery; D007866:Leg / Q000098:blood supply; D008297:Male; D009392:Nephrectomy; D018714:Radiotherapy, Adjuvant; D013997:Time Factors; D019043:Vascular Neoplasms / Q000556:secondary*