Title: Early Brain Metastasis in a Case of Aggressive Renal Cell Carcinoma: A Case Report

Authors: Ramakant Tiwari, Rahat Hadi, Ashish Singhal, Satyajeet Rath

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i2.123

Abstract

Renal cell carcinoma (RCC) accounts for approximately 2% of malignancies worldwide with about 3,00,000 cases diagnosed per year and 1,00,000 deaths with the highest incidence occurring in Western countries.[1]Brain metastasis from  RCC  occurs approximately  in 8% of patients with metastatic RCC (mRCC). The guidelines from the National comprehensive cancer network (NCCN), European Association of Urology (EAU), and American Urological Association (AUA) recommend cerebral imaging only in patients who have symptomatology. The purpose of our case report was to review the presenting symptomatology and to assess prognostic factors for early brain metastasis followed by their overall treatment and survival. Patients presenting with brain metastases from renal cell carcinoma portend a poor prognosis, with a reported median survival of 4-6 months.Here, we present an interesting case report of 58years old male diagnosed as renal cell carcinoma, underwent Right Radical nephrectomy and developed brain metastases within a month of surgery.

Keywords: Brain metastasis, renal cell carcinoma, metastatic RCC.

References

1.      Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010; 127:2893–2917.

2.      Jayson M, Sanders H. Increased incidence of serendipitously discovered renal cell carcinoma. Urology 1998 Feb;51(2):203-5.

3.      Jemal A, Murray T, Ward E, et al. Cancer statistics, 2005. CA Cancer J Clin. 2005;55:10–30.

4.      T. Shuto, S. Inomori, H. Fujino, et al. Gamma knife surgery for metastatic brain tumors from renal cell carcinoma J Neurosurg, 105 (2006), pp. 555–560

5.      M. Wronski, M.H. Maor, B.J. Davis, et al. External radiation of brain metastases from renal carcinoma: A retrospective study of 119 patients from the M. D. Anderson Cancer CenterInt J RadiatOncolBiolPhys, 37 (1997), pp. 753–759

6.      Muacevic, M. Siebels, J.C. Tonn, et al. Treatment of brain metastases in renal cell carcinoma: Radiotherapy, radiosurgery, or surgery.

7.      Lam JS, Leppert JT, Figlin RA, Bellde-grun AS. Surveillance following radical or partial nephrectomy for renal cell carcinoma. CurrUrol Rep. 2005;6:7–18.

8.      Capitanio U, Cloutier V, Zini L, et al. A critical assessment of the prognostic value of clear cell, papillary and chromophobe histological subtypes in renal cell carcinoma: a population-based study. BJU Int 2009 Jun;103(11)

9.      Nieder C, Spanne O, Nordoy T, et al. Treatment of brain metastases from renal cell cancer. UrolOncol, 29 (2011), pp. 405–410.

10.  Ljungberg, N.C. Cowan, D.C. Hanbury, M. Hora, M.A. Kuczyk, A.S. Merseburger, et al. EAU guidelines on renal cell carcinoma: the 2010 updateEurUrol, 58 (2010), pp. 398–406.

Corresponding Author

Ramakant Tiwari

Dr.RMLIMS