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CASE REPORT
Year : 2004  |  Volume : 20  |  Issue : 2  |  Page : 57-58
 

Metastatic mucinous cystadenocarcinoma in solitary kidney- A rare presentation of occult ovarian primary


SGPGIMS, Lucknow, India

Correspondence Address:
Aneesh Srivastava
Department of Urology & Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, UP
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Singh V, Srivastava A. Metastatic mucinous cystadenocarcinoma in solitary kidney- A rare presentation of occult ovarian primary. Indian J Urol 2004;20:57-8

How to cite this URL:
Singh V, Srivastava A. Metastatic mucinous cystadenocarcinoma in solitary kidney- A rare presentation of occult ovarian primary. Indian J Urol [serial online] 2004 [cited 2019 Nov 14];20:57-8. Available from: http://www.indianjurol.com/text.asp?2004/20/2/57/37173



   Case Report Top


A 35 years old female presented with dull aching right flank pain for 4 months. Her renal function tests were normal. The intravenous urogram showed the right upper polar calices only and left kidney was non-visualized. The spiral CT scan of abdomen and pelvis showed the right solitary kidney with poorly enhancing cyst at the anterior surface of kidney and normal pelvic structures [Figure - 1]. The selective renal angiogram showed the absent vascularity in the region of renal cyst [Figure 2]. The patient was subjected for nephron sparing surgery. The cystic lesion was excised taking 1 cm. of normal renal parenchymal margin. The intraoperative frozen section biopsy for the margins were negative for malignancy. The histopathological examination of the resected specimen revealed it as metastatic mucinous cystadenocarcinoma.

Further immunohistostaining by CA-125 confirmed it as metastatic ovarian malignancy. The patient was later advised for the panhystrectomy but she refused the treatment and died after 6 months because of extensive recurrences.


   Comments Top


Kidneys are one of the most common sites of metastatic dissemination [1] . Most renal metastases are multifocal, and almost all are associated with widespread non renal metastases but occasionally they are large and solitary making them difficult to differentiate from RCC [1] . The flank pain can be the presenting symptom as in our patient [1] . The cystic renal metastasis from occult ovarian cancer has not been reported earlier [1] . The CT scan scan is the primary diagnostic tool which typically shows moderately enhancing pattern and arteriography usually shows a hypovascular pattern [1] . The nephron sparing surgery was done because of solitary kidney and its long term result has been reported [ 2]. The histopathological examination and immunohistostaining by CA-125 confirmed it to be a case of metastatic mucinous cystadenocarcinoma of ovary [3] . The patient was advised for the panhystrectomy but she refused the treatment and died after 6 months because of extensive recurrences.

 
   References Top

1.Pollak H.M., Banner M.P, Amendola M.A.: Other malignant neoplasm of the renal parenchyma: Semin. Roentgenol.22(4):260-274;1987.  Back to cited text no. 1    
2.FerganyA.F., Hafez K.S., NovickA.C.: Long term results of nephron sparing surgery for localized renal cell carcinoma : 10 years follow-up. J. Urol. 163:442445:2000.  Back to cited text no. 2    
3.De Vita V.T., Hellman S., Rosenberg S.A: Cancers: principles and practices of oncology, 6th edition,Connecticut ( Philadelphia), 2002, page 1600.  Back to cited text no. 3    


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