Metastatic Renal Cell Cancer In The Absence Of Tumour In Primary Organ

SHORT COMMUNICATION

Abstract

Background: to examine case reports that detail the presentation, diagnosis, and management of metastatic renal cell carcinoma (RCC)occurring in the absence of a detectable primary tumor in the kidneys. The most common presentation involves lymph nodes, with varying clinical manifestations such as pain, hematuria, confusion, mass, lymph node enlargement, or biochemical changes like
hyperkalemia. Case reports illustrate clear cell RCC as the most common histopathology, often presenting as lymph node masses. Immunohistochemical staining is typically positive for Valentin, cytokeratin, and CD 10. The prognosis for mRCC CUP with Immunotherapy and Tyrosine Kinase Inhibitors (TKIs) has shown promising responses with or without surgery, better than metastatic
RCC. The decision for treatment needs an individualized approach as recommended by the specific CUP MDT arranged.

Objectives: To summarize and evaluate reported cases of metastatic RCC presenting without a primary renal tumor.

Methods: This Study Conducted in the Department of Urology, Whiston Hospital, Prescot, Liverpool, England. Targeted literature search was performed based on PubMed and Google Scholar (2013-2023) with such search terms as metastatic renal cell carcinoma without primary and CUP RCC. Case representations were embraced where they encompass specimens of histologically ascertained
metastatic RCC isolated with no identifiable renal mass and also those that implicate affirmative immunohistochemistry (e.g., PAX8, CD10). The information on presentation, imaging, pathology, treatment and outcomes were extracted. A description analysis was made and the results coded in table form to bring out the trends of diagnosis and management.

Conclusions: Isolated metastatic lesions (established by immunohistochemistry (PAX8, CD10)) were found in all patients. Depending on the location of the lesion, targeted therapy (TKI/TF +/- immunotherapy) and surgeries were employed. Positive results were registered under individualized treatment regimens.Confusion: CUP-mRCC is uncommon and can be treated with the multidisciplinary approach that should incorporate the following elements: imaging, IHC, targeted therapy, and surgical resection whenever possible.