RENAL

CELL

URINARY

CARCINOMA

TO

BLADDER

DAVID F. MOBLEY, THOMAS

METASTATIC

M.D.

H. GUTHRIE,

M.D.

From the Roy and Lillie Cullen Department of Urologic Research, the Ralph A. Johnston Laboratory, Division of Urology, Baylor College of Medicine, and the Urology Service of St. Luke’s Episcopal Hospital, Houston, Texas

- A case is presented of renal cell carcinoma metastatic to the urinary bladder. The rarity of this lesion makes it worthy of report.

ABSTRACT

FIGURE 1. (A) Large mass in upper pole of left kidney (arrows). (B) Deformity in bladder wall consistent with tumor (arrow).

UROLOGY

/ JULY 1976 / VOLUME

VIII,

NUMBER

1

53

FIGURE 2. (A) Low-power photomicrograph renal cell carcinoma.

showing bladder sujace

case the metastasis appeared three years after resection of the primary renal lesion, and a partial cystectomy was performed. Because of the rarity of this lesion, we present this case report. Case Report An eighty-year-old female consulted one of us (T. H. G.) because of intermittent, painless hematuria of about four weeks’ duration. Cystoscopy during an episode of hematuria revealed a bladder tumor, and the patient was hospitalized for further evaluation. Review of systems and physical examination were significant in that they revealed the patient to be in poor health, hypertensive, and in heart failure. Laboratory workup revealed a normal complete blood cell count, serum electrolytes, blood urea nitrogen, and creatinine. Intravenous pyelogram with tomograms revealed a large solid tumor of the upper pole of the left kidney (Fig. 1A). A view of the bladder demonstrated a filling defect consistent with a bladder tumor (Fig. 1B). The patient underwent transurethral resection of the bladder tumor which was pedunculated and measured 2.5 cm. in greatest diameter. Histologically, the tumor was renal cell carcinoma (Fig. 2).

54

of tumw; (B) high-power demonstrating

A nephrectomy was not performed because of the poor physical condition of the patient and the excessive surgical risk, and also because of the unlikelihood of cure in a patient whose tumor had already metastasized to the bladder. In addition, she had no flank symptoms referable to the primary tumor. The mode of metastasis of these lesions is controversial. Some believe that the route of spread is hematogenous while others favor a urinary route of spread. Previous experience with patients with renal cell carcinoma metastatic to the bladder reveals an extremely grave prognosis. No long-term survivors of this rare lesion have been reported.‘s3 Baylor College of Medicine 1200 Moursund Houston, Texas 77025 (DR. MOBLEY) References 1. ALARCON,H., and MELICK, W. T.: Metastatic hypernephroma to the bladder, J. Urol. 99: 387 (1968). 2. BUTLER, M. J.: A solitary metastasis to the bladder from a renal adenocarcinoma, Br. J. Urol. 46: 584 (1974). 3. MACALPINE,J. B.: Implantation of secondaries from a renal carcinoma (hypemephroma) within the ureteric lumen, ibid. 36: 164 (1948).

UROLOGY I JULY 1976 /

VOLUME VIII, NUMBER 1

Renal cell carcinoma metastatic to urinary bladder.

RENAL CELL URINARY CARCINOMA TO BLADDER DAVID F. MOBLEY, THOMAS METASTATIC M.D. H. GUTHRIE, M.D. From the Roy and Lillie Cullen Department...
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