A case of metastatic renal cell carcinoma in carcinomatous pleurisy without lung metastasis

Abstract

A 70-year-old woman was referred to our hospital because of cough and dyspnea. Computed tomography (CT) showed left pleural effusion with mediastinal deviation, and irregular diffuse thickening of the left pleura. Pleural effusion cytology did not confirm malignant findings, and tumor markers were negative. Malignant pleural mesothelioma and primary lung cancer were considered as differential diagnoses. Thoracoscopic pleural biopsy was performed. Pathologically, based on various immunostainings, renal cell carcinoma or uterine ovarian cancer was suspected. Abdominal contrast CT showed a left renal tumor. Left nephrectomy was performed. Although pulmonary metastasis of renal cell carcinoma is not rare, instances without pulmonary metastasis and only carcinomatous pleurisy, as in the present case, are limited to only six reported cases. We report this case along with a literature review.