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Cervical Lymph Node Metastasis in Chromophobe Renal Cell Carcinoma: A Case Report and Review of the Literature

DOI: 10.1155/2013/814175

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Abstract:

The metastasis of chromophobe renal cell carcinoma to head and neck region, described herein, has never been reported before to our knowledge. A 56-year-old woman with a history of nephrectomy, that revealed chromophobe renal cell carcinoma six years before, presented left cervical mass. Imaging showed with left cervical lymphadenopathies and thyroid nodule. Surgery with histopathological examination confirmed that it was a left central and lateral jugular lymph node metastasis of chromophobe renal cell carcinoma treated postoperatively by antiangiogenic therapy. The patient was successfully treated by surgery and antiangiogenic drugs with stabilization and no recurrence of the metastatic disease. The case and the literature reported here support that chromophobe renal cell carcinoma can metastasize to the head and neck region and should preferentially be treated with surgery and antiangiogenic therapy because of the associated morbidity and quality-of-life issues. 1. Introduction Renal cell carcinoma represents 3% of all adult malignant tumors [1]. Chromophobe renal cell carcinoma is a unique and infrequent subtype that comprises approximately 3% to 5% of all hypernephromas [2]. Although renal cell carcinoma is the third most common infraclavicular neoplasm that metastasizes to the head and neck region. Liver and lung are the most common sites of metastasis for chromophobe renal cell carcinoma that has better prognosis and lower potential to metastasize than the other subtypes of the hypernephroma [3, 4]. This case report and review of the literature describes a cervical lymph node metastasis in chromophobe renal cell carcinoma that has never been reported before in a large database search. 2. Patient and Methods A 56-year-old female was admitted, in November 2011, to our department with a complaint of masse in her left neck region gradually evolved since 7 months with palpitations. The patient is asthmatic treated by Salbutamol, is hypertense with no treatment followed since 2009, and is treated for pulmonary tuberculosis 33 years ago. The past medical history of the patient included a left nephrectomy without therapeutic supplement in 2006 for renal tumoral syndrome revealed by left chronic lumbar pains. The pathological analysis revealed chromophobe renal cell carcinoma, T2N0Mx stage II, Fuhrman nuclear grade 2, and no sarcomatoid or papillary or tumor necrosis components were identified. A physical examination of the patient showed a painless left cervical masse; its greatest diameter is 04?cm with hard consistency. The thyroid function tests were

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