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Kidney >

Metastatic Tumors

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Definition

Tumors of extrarenal origin that secondarily involve the kidney.

Clinical Features

• Renal involvement:

o  part of a disseminated process

o rarely of clinical significance1,2 

o may appear years or decades after removal of the primary tumor 3

• Microscopic hematuria in 31%4

Gross Pathology

• Commonest primary sites:

o lung

o skin (malignant melanoma)

o  breast

o gastrointestinal tract

o  pancreaso ovary

o testis5,6

Histopathology

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• Sometimes limited to the renal glomeruli in an intracapillary or extracapillary

fashion7,8

Diagnosis

• If limited to the renal glomeruli may be diagnosed by needle biopsy7,8

Other Investigations

• CT scan:

o renal metastases tend to be:

small

multiple

 bilateral wedge shaped

intracortical less exophytic than primary renal cell carcinoma9

Differential Diagnosis

Select up to 2 differential diagnoses to compare with Metastatic Tumors

Renal Cell Carcinoma (Conventional Type) (View full diagnosis)

Renal Sarcomas (View full diagnosis)

Renal cell carcinoma

• In contrast to renal cell carcinoma, bilateral in >50% of cases4

Primary renal tumor

• Metastatic tumors to the kidney simulating primary renal tumors:

o SETTLE

o adenoid cystic carcinoma of breast10 o the follicular variant of papillary thyroid carcinoma11

References

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1 Davis RI, Corson JM. Renal metastases from well-differentiated follicular thyroid

carcinoma. A case report with light and electron microscopic findings. Cancer.

1979;43:265–268.

2 Herzberg AJ, Bossen EH, Walther PJ. Adenoid cystic carcinoma of the breast

metastatic to the kidney. A clinically symptomatic lesion requiring surgical management.Cancer. 1991;68:1015–1020.

3 Johnson MW, Morettin LB, Sarles HE, Zaharopoulos P. Follicular carcinoma of thethyroid metastatic to the kidney 37 years after resection of the primary tumor. J Urol.

1982;127:114–116.

4 Wagle DG, Moore RH, Murphy GP. Secondary carcinomas of the kidney. J Urol.

1975;114:30–32.

5 Bates AW, Baithun SI. The significance of secondary neoplasms of the urinary and

male genital tract. Virchows Arch. 2002;440:640–647.

6 Tamboli P, Abrahams NA, Wright ET, Ro JY, Ayala AG. Metastases to the kidney: a

clinicopathologic analysis of 50 cases (Abstract). Mod Pathol. 2003;16:172a.

7 Belghiti D, Hirbec G, Bernaudin JF, Pariente EA, Martin N. Intraglomerular metastases. Report of two cases. Cancer. 1984;54:2309–2312.

8 Toth T. Extracapillary tumorous metastatic crescents in glomeruli of the kidney. Pathol

Res Pract. 1987;182:240–243.

9 Honda H, Coffman CE, Berbaum KS, Barloon TJ, Masuda K. CT analysis of metastaticneoplasms of the kidney. Comparison with primary renal cell carcinoma. Acta Radiol.1992;33:39–44.

10 Colome MI, Ro JY, Ayala AG, El-Naggar AK, Siddiqui RT, Ordonez NG. Adenoid

cystic carcinoma of the breast metastatic to the kidney: an unusual site of initial distantmetastasis, mimicking a primary renal tumor. J Urol Pathol. 1996;4:69–78.

11 Gamboa-Dominguez A, Tenorio-Villalvazo A. Metastatic follicular variant of 

 papillary thyroid carcinoma manifested as a renal neoplasm. Endocr Pathol.

1999;10:265–268.

Last updated: 1 Mar 2006

Metastatic Tumors

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• Definition

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• Clinical Features

• Gross Pathology

• Histopathology

• Diagnosis

• Other Investigations

•

Differential Diagnosis• References

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