Metastasis of Renal Cell Carcinoma to Spinal Hemangioblastoma in a Patient with von Hippel–Lindau Disease: A Case Report

• WAKITA Shogo

  Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba, Chiba, Japan Department of Neurosurgery, Narita Red Cross Hospital, Chiba, Chiba, Japan

• TAMIYA Ado

  Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba, Chiba, Japan Department of Neurosurgery, Higashi Funabashi Hospital, Chiba, Chiba, Japan

• HIGUCHI Yoshinori

  Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba, Chiba, Japan

• KIKUCHI Hiroshi

  Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba, Chiba, Japan

• KUBOTA Masaaki

  Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba, Chiba, Japan

• IKEGAMI Shiro

  Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba, Chiba, Japan

• HORIGUCHI Kentaro

  Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba, Chiba, Japan

• IKEDA Junichiro

  Department of Diagnostic Pathology, Chiba University Graduate School of Medicine, Chiba, Chiba, Japan

• IWADATE Yasuo

  Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba, Chiba, Japan

抄録

von Hippel–Lindau (VHL) disease is characterized by neoplastic and cystic lesions, such as central nervous system (CNS) hemangioblastoma and clear cell renal cell carcinoma (RCC), arising in multiple organs. Here, we report a case of an RCC that metastasized to a spinal hemangioblastoma in a patient diagnosed with VHL disease. This is a unique case study because visceral neoplasms rarely metastasize to the CNS. The patient had undergone posterior fossa surgery for the removal of hemangioblastomas in the right cerebellar hemisphere as a child. He was diagnosed with RCC at the age of 20 years, and he underwent partial nephrectomy at the age of 35 years. The patient underwent surgical removal of a spinal tumor from Th8, which was also diagnosed as a hemangioblastoma at the age of 40. However, the residual spinal tumor rapidly regrew within 1.5 years. A second surgery was performed due to progressive leg motor weakness. The resected tumor from the second surgery had two distinct components between the tumor center and the margin. Immunohistochemistry of CD10, PAX 8, and inhibin A demonstrated the predominant region of the tumor was RCC. Pathological findings confirmed tumor-to-tumor metastasis of the RCC migrating into residual spinal hemangioblastoma. It can be challenging to distinguish hemangioblastoma from RCC in neuroimaging. We suggest that tumor-to-tumor metastasis should be considered as a differential diagnosis if benign tumors grow rapidly, even if the pathological diagnosis does not initially confirm malignancy. The biological mechanisms of RCC migrating into residual hemangioblastoma are discussed.

収録刊行物

• NMC Case Report Journal

  NMC Case Report Journal 8 (1), 129-135, 2021

  一般社団法人 日本脳神経外科学会

キーワード

• von-Hippel–Lindau disease
• hemangioblastoma
• renal cell carcinoma
• tumor-to-tumor metastasis

詳細情報

• CRID: 1390288292974130816
• NII論文ID: 130008049308
• DOI: 10.2176/nmccrj.cr.2020-0143
• ISSN: 21884226
• Web Site: https://www.jstage.jst.go.jp/article/nmccrj/8/1/8_cr.2020-0143/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2022122735
• 本文言語コード: en
• データソース種別:
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  • Crossref
  • CiNii Articles
  • KAKEN
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