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2016 ; 95
(15
): e3314
Nephropedia Template TP
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English Wikipedia
Thyroid-Like Follicular Carcinoma of the Kidney in a Patient with Skull and
Meningeal Metastasis: A Unique Case Report and Review of the Literature
#MMPMID27082575
Dong L
; Huang J
; Huang L
; Shi O
; Liu Q
; Chen H
; Xue W
; Huang Y
Medicine (Baltimore)
2016[Apr]; 95
(15
): e3314
PMID27082575
show ga
Thyroid-like follicular carcinoma of the kidney (TLFCK) is an extremely rare
subtype of renal cell carcinoma with close resemblance to the well-differentiated
thyroid follicular neoplasms. TLFCK has not been included in the 2004 World
Health Organization (WHO) classification due to the limited data available. Only
27 cases have been reported in the literature to date. Herein, we report a unique
case of TLFCK that presented as a striking skull and meningeal metastasis 5 years
after the initial diagnosis; this is the first case of TLFCK with such a novel
metastasis pattern. A 68-year-old woman was found to have a right renal lesion
using computed tomography (CT) during her regular clinical follow-up visit for
bladder cancer, but she exhibited no obvious clinical symptoms. The CT scan
showed a 4.4-cm diameter, slightly lobulated soft tissue mass in the right lower
kidney, the pathological findings of which showed a TLFCK. Five years later, the
patient had progressed to skull and meningeal metastasis. Both the renal tumor
and the metastasis lesion were composed almost entirely of follicles with a
dense, colloid-like material that resembled thyroid follicular carcinoma.
However, no lesion was found in the thyroid gland. The neoplastic epithelial
cells were strongly immunoreactive for cytokeratin 7 (and vimentin but negative
for thyroid transcription factor-1 and thyroglobulin. This is the first reported
case of TLFCK to consist of widespread metastases to the skull and meninges and
provides evidence that this rare variant of renal cell carcinoma has uncertain
malignant potential and can be more clinically aggressive than previously
believed.