Abstract:
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…show more content…
In this case the fine needle aspiration cytology of cervical lymph node was suggestive of renal cell carcinoma. However the final histopathology of the specimen was suggestive of papillary variant of renal cell carcinoma. Similar case was reported by Behnes CL et al[6] in which a young woman with hereditary leiomyomatosis with metastasized papillary renal cell carcinoma was primarily diagnosed with cervical lymph node enlargement. Literature suggests that solitary metastatic renal cell carcinoma may generally be surgically resected with 5-year survival rates of 30% to 60%.[7] In general, the chemotherapy or radiation therapy is ineffective in renal cell carcinoma but immunotherapy (recombinant human interleukin-2 and interferon-alpha) has been developed as new modality with overall response rate of 15%– 20%.[8] Temsirolimus (m-TOR inhibitor) is the preferred drug for papillary variant of renal cell carcinoma with median overall survival of 11.6 months.(National Comprehensive Cancer Network guidelines - category 1 recommendation).[9] Due to the lack of availability of immuno-histochemistry in our institute, we could not perform the detailed genetic analysis and sub typing of this papillary cell carcinoma. The local recurrence of renal cell carcinoma after radical nephrectomy, occurs
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