Metachronous bladder metastasis from clear cell renal cell carcinoma

Abstract

Bladder metastasis, either synchronous or metachronous, is an uncommon presentation of renalcell carcinoma. We herein report a metachronous bladder metastasis from renal cell carcinoma ofclear cell type, and review the current literature on the presentation, management and prognosisof this kind of metastasis. A 77-year-old man was presented to Queen Mary Hospital, Hong Kongin 2011 with hematuria, subsequently found a renal tumor invading into renal pelvis. Open rightradical nephrectomy was performed and the tumor was confirmed to be pT1b clear cell carcinomaof Fuhrman grade 2. He remained asymptomatic all along after nephrectomy, but surveillanceultrasonography (USG) revealed a 2.2 cm bladder neck mass in 23 months after nephrectomy.After patient refused transurethral resection, the mass further enlarged to 3.8cm one year later.Transurethral resection was performed and histopathological examination confirmed clear cellcarcinoma, with no fibro-muscular invasion. Multiple pulmonary metastases were also found oncomputed tomography (CT) of the thorax. He refused target therapy and preferred conservativetreatment. He remained symptom-free 2 months after the transurethral resection.