Abstract
Metastases that affect the distal regions of the upper and the lower extremities are called acrometastases and they affect the bones and the overlying tissues. Various cancer types may have single or multiple acrometastases. A sixty-four-year-old female patient had a painful and enlarging mass at the tip of the fifth digit of her right hand. The lesion appeared as a red macule at the junction between the nail plate and the hyponychium. The patient was in her seventh postoperative year after a left-sided total nephrectomy with a histopathological diagnosis of renal clear cell carcinoma. Due to multiple metastases to the spleen and left femoral head, she had been treated with twenty sessions of radiotherapy and she was under nivolumab therapy twice a month for two years. A punch biopsy revealed a gland forming, CD 10, PAX 8 and vimentin-positive renal clear cell carcinoma metastasis. The patient was treated with amputation of the distal phalanx. Although rare, acrometastasis should be included in the differential diagnosis of patients with a history of renal clear cell carcinoma.
Project Number
YOKTUR.
References
- Flynn C, Danjoux C, Wong J, Christakis M, Rubenstein J, Yee A, et al. Two cases of acrometastasis to the hands and review of the literature. Curr Oncol 2008;15(5):51-8. [CrossRef] google scholar
- Milionis V, Vlachodimitropoulos D, Goutas D, Goutas N. Acrometastases in Renal Cell Carcinoma: A Case Report and Review of Literature. Clin Oncol Case Rep 2020;2:2. google scholar
- Rommer E, Leilabadi SN, Lam G, Soltani A, Ellis CV, Rizvi M, et al. Metastasis of hepatocellular and renal cell carcinoma to the hand. Plast Reconstr Surg Glob Open 2014;1(9):e83. [CrossRef] google scholar
- Hernández-Cortés P, Caba-Molina M, Gómez-Sánchez R, Ríos-Peregrina R. Renal clear cell carcinoma acrometastasis. an unusual terminal condition. J Hand Microsurg 2015;7(01):149-51. [CrossRef] google scholar
- Kamala LH, Ranjith S, Benson R. Cutaneous acral metastasis from renal cell carcinoma—a case report. Indian J Surg Oncol 2019:1-3. https://doi.org/10.1007/s13193-019-00961- 2. [CrossRef] google scholar
- Capitanio U, Bensalah K, Bex A, Boorjian SA, Bray F, Coleman J, et al. Epidemiology of renal cell carcinoma. Eur Urol 2019;75(1):74-84. [CrossRef] google scholar
- Padala SA, Barsouk A, Thandra KC, Saginala K, Mohammed A, Vakiti A, et al. Epidemiology of renal cell carcinoma. World J Oncol 2020;11(3):79-87. [CrossRef] google scholar
- Ljungberg B, Albiges L, Abu-Ghanem Y, Bedke J, Capitanio U, Dabestani S, et al. European Association of Urology guidelines on renal cell carcinoma: the 2022 update. Eur Urol. 2022. [CrossRef] google scholar
- Wolfe SW, Pederson WC, Kozin SH, Cohen MS. Green’s Operative Hand Surgery. Two Volumes. 5th Edition. Elsevier, Churchill Livingstone. 2005. google scholar
Abstract
Üst ve alt ekstremitenin distal kısımlarını etkileyen metastazlara akrometastaz denir ve bu tabloda, kemikler ve üzerlerindeki dokular etkilenir. Farklı kanser türleri tekli veya çoklu akrometastazlar yapabilir. Altmış dört yaşındaki bir kadın hasta, sağ elinin beşinci parmağının ucunda ortaya çıkan ağrılı ve sürekli büyüyen bir kitle ile polikliniğe başvurmuştur. Lezyon, tırnak plağı ve hiponişyum kesişimindeki kırmızı bir maküldür. Hasta, yedi yıl önce histopatolojik tanısı renal berrak hücreli karsinom olan bir kitle nedeniyle sol taraflı total nefrektomi geçirmiştir. Hastanın dalağında ve sol femur başında çoklu metastazları olduğundan hastaya yirmi seans radyoterapi uygulanmıştır. Hastaya son iki yıldır, ayda iki kez nivolumab tedavisi verilmiştir. Yapılan punch biyopside CD 10, PAX 8 ve vimentin pozitif olan ve gland oluşturan renal berrak hücreli karsinom metastazı saptanmıştır. Hastaya distal falanks ampütasyonu ameliyatı yapılmıştır. Renal berrak hücreli karsinom öyküsü olan hastalarda görülen parmak lezyonlarının ayırıcı tanısında, nadir de olsa akrometastaz göz önünde bulundurulmalıdır.
Supporting Institution
YOKTUR.
Project Number
YOKTUR.
References
- Flynn C, Danjoux C, Wong J, Christakis M, Rubenstein J, Yee A, et al. Two cases of acrometastasis to the hands and review of the literature. Curr Oncol 2008;15(5):51-8. [CrossRef] google scholar
- Milionis V, Vlachodimitropoulos D, Goutas D, Goutas N. Acrometastases in Renal Cell Carcinoma: A Case Report and Review of Literature. Clin Oncol Case Rep 2020;2:2. google scholar
- Rommer E, Leilabadi SN, Lam G, Soltani A, Ellis CV, Rizvi M, et al. Metastasis of hepatocellular and renal cell carcinoma to the hand. Plast Reconstr Surg Glob Open 2014;1(9):e83. [CrossRef] google scholar
- Hernández-Cortés P, Caba-Molina M, Gómez-Sánchez R, Ríos-Peregrina R. Renal clear cell carcinoma acrometastasis. an unusual terminal condition. J Hand Microsurg 2015;7(01):149-51. [CrossRef] google scholar
- Kamala LH, Ranjith S, Benson R. Cutaneous acral metastasis from renal cell carcinoma—a case report. Indian J Surg Oncol 2019:1-3. https://doi.org/10.1007/s13193-019-00961- 2. [CrossRef] google scholar
- Capitanio U, Bensalah K, Bex A, Boorjian SA, Bray F, Coleman J, et al. Epidemiology of renal cell carcinoma. Eur Urol 2019;75(1):74-84. [CrossRef] google scholar
- Padala SA, Barsouk A, Thandra KC, Saginala K, Mohammed A, Vakiti A, et al. Epidemiology of renal cell carcinoma. World J Oncol 2020;11(3):79-87. [CrossRef] google scholar
- Ljungberg B, Albiges L, Abu-Ghanem Y, Bedke J, Capitanio U, Dabestani S, et al. European Association of Urology guidelines on renal cell carcinoma: the 2022 update. Eur Urol. 2022. [CrossRef] google scholar
- Wolfe SW, Pederson WC, Kozin SH, Cohen MS. Green’s Operative Hand Surgery. Two Volumes. 5th Edition. Elsevier, Churchill Livingstone. 2005. google scholar
Details
| Primary Language | English |
|---|---|
| Subjects | Health Services and Systems (Other) |
| Journal Section | Case Reports |
| Authors | |
| Project Number | YOKTUR. |
| Publication Date | October 26, 2023 |
| Submission Date | May 2, 2023 |
| Published in Issue | Year 2023 Volume: 86 Issue: 3 |
Cite
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Addressi: İ.Ü. İstanbul Tıp Fakültesi Dekanlığı, Turgut Özal Cad. 34093 Çapa, Fatih, İstanbul, TÜRKİYE
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