Abstract
A brain metastasis that occurs more than 10 years after a nephrectomy is rare, and we report herein a case of a cerebral metastasis from a renal cell carcinoma (RCC) 23 years after a nephrectomy. Twenty-three years earlier, the patient had undergone a right nephrectomy due to a renal tumor. Subsequently, lung cancer was diagnosed 17 years after this nephrectomy and a metastatic tumor sited in the left occipital area was extirpated. The histopathological diagnosis was an RCC. In later medical exams, no evidence of recurrence at the prior operative site was noted and the left kidney was normal. This time on hospital admission, a metastatic lung cancer was diagnosed. Although the histological origin of this metastasis was unknown, it may have developed from the RCC. This case appears to indicate that after a long latent period the metastatic route was the transpulmonary pathway via the pulmonary arterial circulation. When deciding on whether surgery should be performed for such cases, the overall preoperative status of the patient should be taken into consideration.
