Metastases of a renal cell carcinoma on the contralateral psoas muscle and thyroid 14 and 17 years after total nephrectomy

Introduction: Solitary metastases in case of renal cell carcinomas occur in only 1.6 to 3.6% of all cases. In such cases, occurrence is mostly observed in the lungs, lymphatic nodes, bones and in the thyroid. Case report: Total right-side nephrectomy was performed in 1981 on a 46-year old male because of a pT2 pND MO second-degree renal cell carcinoma. Total prostatectomy was performed on the same patient in 1993 baecause of a pT3a pNO MO Grade 2b adenocarcinoma of the prostate (PSA 8.9 ng/ml), Two years later sergery of a left-sided psoas muscle metastasis of the renal cell carcinoma was effected. In 1998, the patient now being 63 years of age, 17 years after total nephrectomy and 3 years after having removed the psoas metastasis, he was operated on again; this time total right-side lobectomy and selective left-sided lobectomy of the thyroid (in each case a renal cell carcinoma metastasis) were carried out. Now, one year after the last surgery, the patient is free from any recurrence. Conclusion: At the present time there is no alternative to surgery in case of solitary metastases of a renal cell carcinoma, not even with repeated occurrence.