Introduction. Renal cell carcinomas have a wide range of metastasis and the detection of dissemination in the female reproductive system is extremely rare. We report a case of advanced clear cell renal cell carcinoma with synchronous metastasis in the vagina as the primary manifestation, and a “de novo” synchronous vaginal metastasis at the same site, sixteen months after the initial treatment.
Case presentation. A 60-year-old woman with genital bleeding was admitted to the Oncogynaecological Clinic for the second time. Sixteen months after the initial diagnosis (vaginal metastasis from clear cell renal cell carcinoma), following vaginal metastasectomia and targeted therapy, the patient showed disease progression with an increased size of a vaginal lesion at the same site. Excisional biopsy of the new vaginal lesion was performed. The histological and immunohistochemical examinations confirmed the same morphology and immunoprofile as the initial vaginal tumour. Due to the imaging data showing advanced stage tumour of the left kidney initially, nephrectomy had not been performed.
Conclusions. This case demonstrates a rare site of metastasis of asymptomatic clear cell renal cell carcinoma with a “de novo” vaginal lesion at the same site, following initial excision of the primary vaginal metastasis and targeted therapy; the diagnostic-therapeutic approach and the differential diagnosis are discussed.
Address for correspondence:
Tatyana MARINOVA BETOVA
Department of Pathoanatomy, Medical University – Pleven, Bulgaria
Address: 1, Sv. Kliment Ohridski Str., 5800 Pleven, Bulgaria
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