2020 Volume 34 Issue 1 Pages 40-45
A man in his 50s was admitted to our department due to a pulmonary nodule and mediastinal mass noted on CT. The patient had undergone left nephrectomy and kidney transplantation for chronic renal failure and was diagnosed with renal cell carcinoma based on an examination of the isolated kidney 13 years ago. During follow-up, computed tomography showed a solitary nodular shadow in the upper left lung along with a mass that gradually increased in size in the right mediastinum, so the case was referred to our department. Thoracoscopic resection of the mediastinal tumor was performed with a right-hand approach. Clear cell carcinoma and mediastinal lymph node metastasis of renal cell carcinoma were diagnosed. Two-stage thoracoscopic left upper segment resection was performed for the left upper lung nodule, and the patient was diagnosed with metastatic renal cancer. One year after surgery, no recurrence was noted. Hematogenous metastasis is the most frequent form of metastasis in renal cell carcinoma, but the prognosis is still unknown in cases of resection of lung and contralateral isolated mediastinal lymph node metastases. It may be possible to improve the prognosis by completely resecting isolated lesions with different metastatic routes.