title: Metastatic renal cell carcinoma presenting as multiple pleural tumours.
abstract: A 66-year-old man was admitted with dyspnoea. Chest X-ray and chest computed tomography (CT) demonstrated a left-sided pleural effusion and multiple tumours, suggesting malignant mesothelioma in the left pleural space, but there were no pulmonary lesions. However, abdominal CT revealed a right renal tumour. An ultrasonography-guided needle biopsy of the pleural mass provided evidence of metastatic renal cell carcinoma (RCC). The pleural lesions dramatically decreased in size following right radical nephrectomy and subsequent interferon-alpha treatment. While the thorax is a frequently affected site of RCC, sole pleural metastases are rare and are often secondary to lung involvement. Batson's plexus, a network of vertebral valve-less veins with multiple connections, is likely responsible for the contralateral pleural metastases of RCC.
authors.affiliation: Second Department of Internal Medicine, Ehime University School of Medicine, Onsen-gun, Ehime, Japan. honi@hiroshima-u.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohnishi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Abe
authors.forename: Hironobu
authors.initials: H
authors.lastname: Hamada
authors.forename: Akihito
authors.initials: A
authors.lastname: Yokoyama
authors.forename: Takeru
authors.initials: T
authors.lastname: Hirayama
authors.forename: Ryoji
authors.initials: R
authors.lastname: Ito
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Nishimura
authors.forename: Jitsuo
authors.initials: J
authors.lastname: Higaki
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000556:secondary*; D003937:Diagnosis, Differential; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis; D016066:Pleural Effusion, Malignant / Q000473:pathology; D010997:Pleural Neoplasms / Q000473:pathology / Q000556:secondary*