Renal Cell Carcinoma with Solitary Vaginal Metastasis Authors: University of Oklahoma Department of Urology Disclosure of conflict of interests: Abstract Background: Solitary vaginal metastasis of renal cell carcinoma is extremely rare. Case: We present a 71 year-old woman with a history of a stage T4,Nx,M1 renal cell carcinoma status post laparoscopic nephrectomy who presents with a vaginal mass. Imaging demonstrated a solid vaginal tumor suspicious for metastatic disease with no evidence of additional metastases. Excisional biopsy of the vaginal mass was consistent with renal cell carcinoma. Conclusions: Although rare, metastatic renal cell carcinoma can present as a solitary vaginal mass. Key Words: renal cell carcinoma, …show more content…
Further work up with computed tomography (CT) revealed a renal tumor (Figure 1.1) and a peri-urethral vaginal mass(Figure 1.2). The renal tumor was confirmed to be RCC, at which time she underwent a Laparoscopic Nephrectomy in February 2014. Subsequently she was referred to our service for evaluation of the vaginal mass. Figure 1.1 Figure 1.2 On examination in April 2014 Magnetic Resonance Imaging (MRI) was ordered to further characterize the vaginal mass. Pelvic T2 weighted MRI demonstrated a 2.3 x 2.5 x 2.9 cm mass infiltrating the right vaginal wall displacing the urethra to the left suspicious for metastatic disease (Figure 2.1). A positron emission tomography (PET) scan was ordered to evaluate for other possible locations of metastasis. PET scan revealed an unchanged vaginal mass and no evidence of additional metastasis (Figure 3.1). Excisional biopsy of the vaginal mass was consistent with metastatic RCC. Excisional biopsy of the cervix found no evidence of malignancy. Figure 2.1 Figure 3.1 At this point the patient was counseled about her options for proceeding. The patient elected to undergo a vaginal mass excision instead of a total vaginectomy despite the increased risk for recurrence. Subsequently the vaginal mass was excised and sent to pathology. Pathology revealed a 2.5 x 2 x 2 cm vaginal
Malignant struma ovarii tumors are divided into three categories on the basis of histology. (17) The first papillary type is the most common characterized by overlapping nuclei or ground glass appearance. The second follicular type is characterized by vascular or capsular invasion (10). The third type is follicular variant of papillary carcinoma. Metastasis is very rare in case of malignant struma ovarii (5%) which follows the pattern of ovarian tumor. It can metastasize to pelvic, para-aortic lymph nodes, direct spread to omentum and peritoneal cavity and hematologic spread to lung, bone, liver and brain (11, 12). There are a lot of difficulties in the clinical diagnosis of struma ovarii due to the absence of specific diagnostic criteria. The imaging studies used in diagnosing struma ovarii are ultrasonogram, CT and MRI. The findings on imaging studies are also nonspecific. Triple-contrast CT scan of the abdomen and pelvis should be performed to evaluate the extent of disease and the involvement of lymph nodes and other adjacent structures (e.g., bowel). Typically, struma ovarii appear as a multicystic mass with no or moderate cystic wall enhancement. In addition to basic metabolic panel CA-125, CEA, CA19-9 tumor markers along with Iodine-125 uptake are performed preoperatively. CA-125 is found to be
9. A 72-year-old patient with a history of breast cancer has a suspicious mass in her uterus. A biopsy was done. The determination was that the patient had a carcinoma in situ of the uterus. The physician who conducted the surgery called a face-to-face meeting with his fellow surgeons, the patient and the patient's family and discussed the case and the patient's outcome for 30 minutes.
cervical tumor. Her doctor, Howard Jones then took a biopsy and sent it off for testing in
with post Hoc LSD was used , T- test was used to compare between the benign and
There was perhaps just a little bit of erythema, particularly at the six o'clock position. No vaginal mucosal lesions were noted. The cervix appeared normal. There was a thinner yellowish discharge in the vault, that had a somewhat fishy odor.
Assessment: A 48-year-old Caucasian female with history of end-stage renal disease secondary to type 1 diabetes, multiple comorbidities, including severe peripheral vascular disease, recurrent neurotrophic foot ulcers, status post multiple debridements, aortoiliac vascular disease, status post aortobifemoral bypass, bilateral femoral popliteal bypass, history of vaginal warts secondary to HPV, status post incomplete radiation and chemotherapy.
She reports a history of back pain, ovarian cysts excision, and breast tumor. She denies chest pain, shortness of breath, or palpitations. Patient reports that her immunizations and preventive care are up to
A 25-year-old female presents to your clinic for evaluation of a mass in the vulvar area. This has been present for the last 1 week and tender to touch, there is no fever and no chills. Upon exam, you noticed that there is a medially protruding mass in the introitus area around a radius of 1.5 cm and tender to touch with some induration around the area. You advised the patient that the most likely diagnoses in this case are:
Kidney cancer is a cancer that begins in the kidneys. Cancer begins when cells in the body start to become uncontrollable. Cells in almost any part of the body can get to become cancerous, and can spread to different parts of the body. Renal cell carcinoma also called renal cell disease or renal cell adenocarcinoma, is by a wide margin the most well known sort of kidney cancer. Around 9 out of 10 kidney cancers are renal cell carcinomas. Despite the fact that RCC typically develops as a solitary tumor inside a kidney, at or more tumors in one kidney or even tumors in both kidneys in the meantime. There are a few subtypes of RCC, construct for the most part in light of how the cancer cells look under a magnifying instrument. Knowing the subtype
Renal Cell Cancer, considered as the most fatal cancer of urinary tract is most frequently diagnosed as an incidental finding. Very few cases in literature are noted to present with cervical lymph node enlargement especially solitary. We report a rare case of left renal cell carcinoma in a young female, presenting with left cervical lymphadenopathy. Fine needle aspiration cytology was suspicious of papilloid epithelial malignancy and further work up with contrast enhanced computed tomography scan revealed left renal mass with few left paraortic lymph node involvement, for which radical nephrectomy with
detailed image of the kidneys and other organs, a kidney biopsy where a small piece of
Urine analysis revealed no signs of urinary tract infection. Ultrasound revealed a tumor in the right kidney and a solid papillary mass on right lateral aspect of bladder (Figure 1). At initial presentation, the patient reported a good quality of life and had an Eastern Cooperative Oncology Group performance status (ECOG=0) without further symptoms. The patient underwent X ray chest and abdominal computed tomography (CT) scan. There was no obvious pulmonary lymph nodes. There was renal tumor of the lower kidney pole (50x47x58 mm, Figure 2A, B) with proximal renal vein filling defect suggestive of tumor thrombus and the suspicious bladder lesion (2.1x1.9x1.8 cm, Figure 2C, D). Patient underwent TURBT followed by Left radical nephrectomy. Histopathology of bladder tumor was clear cell RCC whereas that of left renal mass was clear cell RCC stage pT3aNx. Postoperative recovery was uneventful. Restage TURBT after 1 month did not reveal any residual or recurrent
Cervical cancer malignant cancer of the cervix uteris or cervical area. It may present with vaginal bleeding but symptoms may be absent until the cancer is in its advanced stages, which has made cervical cancer the focus of intense screening efforts using the Pap smear. About 2.2 percent of women carry one of the 2 virus strains most likely to lead to cervical cancer. One of the symptoms of Cervical Cancer is very Unusual amount of discharge.
Juxtaglomerular cell tumor (JGCT), or reninoma, is a rare renin producing benign neoplasm arising from the juxtaglomerular cell apparatus, generally affecting young adults and adolescents. Clinically, it presents with secondary hypertension and hypokalemia. Since reninoma is curable by surgical resection, it becomes necessary to consider JGCT as a possible differential in patients presenting with secondary hypertension, hypokalemia and excessive renin secretion. Herein we describe a case of a young female presenting with hypertension and a single renal mass.
Cervical cancer is one type of cancer happening from the cervix due to abnormal growth of cells. There are many reasons to cause cervical cancer. One of them is that the abnormal cells from other parts of body are able to invade or spread to the cervix and cause the abnormal growth. Unfortunately, in early stage, typically no symptoms are seen, and later symptoms may include abnormal vaginal bleeding, pelvic pain, or pain during sexual intercourse. What’s more, when bleeding after sex, it also may indicate the presence of cervical cancer.7