Metastatic Renal cell Carcinoma Presenting as a clear-cell Tumor in Tongue: A Case Report

Document Type: Case Report

Authors

1 Dental research center, Department of oral and maxillofacial pathology of dentistry college, Babol University of Medical Sciences, Babol, Iran.

2 Dental research center, Department of oral medicine and diagnosis of dentistry college, Babol University of Medical Sciences, Babol, Iran.

3 Department of Pathology of medical college, Babol University of Medical Sciences, Babol, Iran.

Abstract

Introduction:
Metastatic lesions of the oral cavity are extremely rare, accounting for approximately 1% of all malignant oral tumors. The most common primary sources of metastatic tumors in the oral region are, from the most to the least common, the breast, lung, kidney, bone, and colon. Renal cell carcinoma accounts for nearly 3% of all adult malignancies. It usually metastasizes to the lungs, bone, adrenal glands, and regional lymph nodes. The incidence of metastasis from renal cell carcinoma to the head and neck region is very low. The tongue is considered a very rare atypical ear, nose, and throat (ENT) location for metastasis of renal cell carcinoma. The present case from Iran reports tongue metastasis of renal cell carcinoma (RCC).
 
Case Report:
The following report is based on an 80-year old male patient with a tongue lesion and ambiguous past medical history that ultimately leads to diagnosis of a metastatic RCC. We also updated a previous literature review that was published 2008. A histopathological differential diagnosis for clear-cell tumors is also discussed.
 
Conclusion: 
Because of the rarity of metastatic tumors of the oral region as well as the presence of other lesions with clear cells, diagnosis of metastatic clear-cell RCC in the oral cavity can be very difficult and challenging.
 

Keywords


1. Will T A, Agarwal N, Petruzzelli G J. Oral cavity metastasis of renal cell carcinoma: A case report. J Med Case reports. 2008; 2:313.

2. Som PM, Norton KI, Shugar JM, Reede DL, Norton L, Biller HF: Metastatic hypernephroma to the head and neck. AJNR Am J Neuroradiol. 1987; 8:1103–6.

3. Boles R, Cemy J: Head and neck metastases from renal carcinomas. Mich  Med. 1971;70:616–8.

4. Jayasooriya PR, Gunarathna IANS, Attygalla AM, Tilakaratne WM. Metastatic renal cell carcinoma presenting as a clear-cell tumour in the head and neck region.  J Oral Oncology EXTRA. 2004; 40:50–3.

5. Azam F, Abubakerr M, Gollins S. Tongue metastasis as an initial presentation of renal cell carcinoma: a case report and literature review. J Med case reports. 2008;47(2):249.

6. Motzer RJ, Hutson TE, Tomczak P, Michaelson MD, Bukowski RM, Rixe O, et al. Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med. 2007; 356(2):115–24.

7. Escudier B, Eisen T, Stadler WM, Szczylik C, Oudard S, Siebels M,et al. Sorafenib in advanced clear-cell renal-cell carcinoma. N Engl J Med 2007, 356(2):125–134.

8. Yoshitomi I, Kawasaki G, Mizuno A, Nishikido M, Hayashi T, Fujita S, Ikeda T. Lingual metastasis as an initial presentation of renal cell carcinoma. Med Oncol. 2011; 28:1389–94.

 9. Basely M, Bonnel S, Maszelin P, Verdalle P, Bussy E, de Jaureguiberry JP. A rare presentation of metastatic renal clear-cell carcinoma to the tongue seen on FDG PET. Clin Nucl Med. 2009 Sep; 34(9):566–9.