Wen HY, Hou J, Zeng H, Zhou Q, Chen N. Tumor-to-tumor metastasis of clear cell renal cell carcinoma to contralateral synchronous pheochromocytoma: A case report. World J Clin Cases 2022; 10(19): 6750-6758 [PMID: 35979292 DOI: 10.12998/wjcc.v10.i19.6750]
Corresponding Author of This Article
Ni Chen, MD, PhD, Doctor, Professor, Department of Pathology, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu 610041, Sichuan Province, China. chenni1@163.com
Research Domain of This Article
Pathology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 6, 2022; 10(19): 6750-6758 Published online Jul 6, 2022. doi: 10.12998/wjcc.v10.i19.6750
Tumor-to-tumor metastasis of clear cell renal cell carcinoma to contralateral synchronous pheochromocytoma: A case report
Hsin-Yu Wen, Jing Hou, Hao Zeng, Qiao Zhou, Ni Chen
Hsin-Yu Wen, Jing Hou, Qiao Zhou, Ni Chen, Department of Pathology, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Hao Zeng, Department of Urology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Wen HY analyzed the data and performed the experiments; Zeng H provided clinical data; Hou J and Chen N reviewed the pathologic material and diagnosis; Wen HY prepared the draft of the manuscript; Zhou Q and Chen N designed and supervised the study, wrote and revised the manuscript.
Supported bythe National Natural Science Foundation of China, No. NSFC 81872107 and No. NSFC 81872108.
Informed consent statement: This study was approved by the Institutional Review Board of West China Hospital of Sichuan University. Written informed consent was obtained from the patient and her family member.
Conflict-of-interest statement: The authors declare no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ni Chen, MD, PhD, Doctor, Professor, Department of Pathology, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Wuhou District, Chengdu 610041, Sichuan Province, China. chenni1@163.com
Received: February 28, 2022 Peer-review started: February 28, 2022 First decision: April 8, 2022 Revised: April 19, 2022 Accepted: April 28, 2022 Article in press: April 28, 2022 Published online: July 6, 2022 Processing time: 115 Days and 22.6 Hours
Abstract
BACKGROUND
Tumor-to-tumor metastasis (TTM) is an uncommon condition. Only a few cases of renal cell carcinoma (RCC) as donor tumor of TTM have been reported in literature, and none of these studies have described RCC metastasizing to synchronous pheochromocytoma (PCC).
CASE SUMMARY
The patient was a 54-year-old woman who presented with recurrent dull abdominal pain for six months, which was further aggravated for one more month. Enhanced computed tomography revealed a tumor mass in the right kidney and another mass in the left retroperitoneum/adrenal gland. Histopathology and immunochemistry of resected specimens confirmed the diagnosis of clear cell renal cell carcinoma (CCRCC) of the right kidney, and the left retroperitoneum revealed a typical PCC with CCRCC metastasis. Whole exome sequencing revealed the presence of a c.529A>T somatic mutation of the Von Hippel Lindau (VHL) gene in the metastasized CCRCC, which was also present in the primary right kidney CCRCC, as confirmed by Sanger sequencing. No VHL mutation was detected in the PCC or in normal right kidney tissue. Fluorescence in situ hybridization revealed loss of chromosome 3p in both the primary right kidney CCRCC and CCRCC metastasized to PCC in the left kidney.
CONCLUSION
This is the first case showing metastasis of CCRCC to PCC, thus leading to tumor-to-tumor metastasis.
Core Tip: Tumor-to-tumor metastasis (TTM) is uncommon. Only a limited number of cases in which renal cell carcinoma (RCC) is the donor tumor of TTM have been reported in the literature, and none of these studies have described RCC metastasizing to synchronous pheochromocytoma (PCC). Here, we report a unique case of clear cell renal cell carcinoma (CCRCC) metastasizing to contralateral retroperitoneal/adrenal PCC; molecular characterization by whole genome sequencing, mutational analysis by Sanger sequencing, and fluorescence in situ hybridization analysis for 3p loss were performed. This is the first case of CCRCC metastasizing to PCC.
