title: Renal metastasis of an ovarian granulosa cell tumour inducing growth of a cystic nephroma.
abstract: A 44-year-old woman presented with a large pelvic mass. Pathology revealed a granulosa cell tumour of the left ovary. The patient was followed after surgery with inhibin B levels and interval imaging. Six years later, she began to experience severe back pain. A vertebral biopsy was positive for metastatic granulosa cell tumour. She underwent radiation to the spine. Inhibin B levels began to rise and, several months later, a CT scan showed a large heterogeneous mass essentially replacing the left kidney. She underwent an open left radical nephrectomy. Pathology revealed a 12 cm cystic nephroma with a 5 cm nodule of metastatic granulosa cell tumour. Immunohistochemistry demonstrated that the mass was inhibin and oestrogen receptor positive. This is a novel presentation of these coexisting pathologies. This unique case sheds light on the possibility of induction of cystic nephroma by the altered hormonal environment created by a granulosa cell tumour metastasis.
authors.affiliation: Department of Urology, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Burns
authors.forename: James S
authors.initials: JS
authors.lastname: Rosoff
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Brooks
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Picard
authors.forename: M Timothy
authors.initials: MT
authors.lastname: Smith
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Picard
mesh_terms: D000328:Adult; D005260:Female; D006106:Granulosa Cell Tumor / Q000150:complications / Q000556:secondary*; D006801:Humans; D052177:Kidney Diseases, Cystic / Q000209:etiology; D007680:Kidney Neoplasms / Q000150:complications / Q000556:secondary*; D010051:Ovarian Neoplasms / Q000473:pathology*