Metastatic renal cell carcinoma presenting as multiple pleural tumours.
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.
Ohnishi
Hiroshi
H
Second Department of Internal Medicine, Ehime University School of Medicine, Onsen-gun, Ehime, Japan. honi@hiroshima-u.ac.jp
Abe
Masahiro
M
Hamada
Hironobu
H
Yokoyama
Akihito
A
Hirayama
Takeru
T
Ito
Ryoji
R
Nishimura
Kazutaka
K
Higaki
Jitsuo
J
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*