A Case of Small Renal Cell Carcinoma Diagnosed by Thoracoscopy Under Local Anesthesia

Abstract

Background. Malignant pleural effusion rarely occurs in patients with renal cell carcinoma. We herein report a case of small renal cell carcinoma diagnosed by thoracoscopy under local anesthesia. Case. A 61-year-old man presented to our department with cough and dyspnea on exertion. Chest imaging showed right pleural effusion with multiple pleural nodular lesions. Thoracoscopy under local anesthesia revealed irregular nodules of various sizes on the parietal pleura. A parietal pleural biopsy confirmed pleural metastasis of renal cell carcinoma. There was no evidence of lymph node metastasis, and the primary tumor size in the greatest dimension was 1.8 cm. At this time, tyrosine kinase inhibitor therapy was initiated. Conclusion. We experienced a case of small renal cell carcinoma diagnosed because of pleural effusion. Malignant pleural effusion is associated with advanced malignancy, so the diagnosis of primary tumor is often clear. However, in this case, the primary tumor was small, and thoracoscopy under local anesthesia was useful for the definitive diagnosis.