Tadataka Hirai

Department of Radiology, Okayama University Hospital, Okayama, Japan

Mayu Uka

Department of Radiology, Okayama University Hospital, Okayama, Japan

Toshihiro Iguchi

Department of Radiology, Okayama University Hospital, Okayama, Japan; Department of Radiological Technology, Faculty of Health Sciences, Okayama University, Okayama, Japan

Kazuya Yasui

Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan

Takahiro Kawabata

Department of Radiology, Okayama University Hospital, Okayama, Japan

Noriyuki Umakoshi

Department of Radiology, Okayama University Hospital, Okayama, Japan

Koji Tomita

Department of Radiology, Okayama University Hospital, Okayama, Japan

Yusuke Matsui

Department of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University

Yasuyuki Kobayashi

Department of Urology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan

Motoo Araki

Department of Urology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan

Takao Hiraki

Department of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University

Keywords

Carcinoma Diaphragm Renal Cell von Hippel-Lindau disease

Abstract

We report the case of a 38-year-old man with two von Hippel-Lindau disease-associated T1a renal cell carcinomas (RCCs) (<2 cm in diameter) which developed into a 2.5-cm solitary diaphragmatic metastatic tumor. After diagnosis using percutaneous biopsy, the diaphragmatic metastasis and two RCCs were treated by laparoscopic resection and percutaneous cryoablation, respectively. One year after treatment, the patient survived without local recurrence or distant metastasis. This report describes a rare case of RCC metastasis in VHL disease and its treatment.

References

1. Binderup MLM, Galanakis M, BudtzJørgensen E, Kosteljanetz M, Luise Bisgaard M. Prevalence, birth incidence, and penetrance of von Hippel-Lindau disease (vHL) in Denmark. Europen Journal of Human Genetics. 2017;25(3):301–7. https://doi.org/10.1038/ejhg.2016.173
2. Maher ER, Yates JR, Harries R, Benjamin C, Harris R, Moore AT, et al. Clinical features and natural history of von Hippel-Lindau disease. Quarterly Journal of Medical Science. 1990;77(283):1151–63. https://doi.org/10.1093/qjmed/77.2.1151
3. Peng　X, Chen J, Wang J, Peng S, Liu S, Ma K, et al. Natural history of renal tumors in von Hippel-Lindau disease: A large retrospective study of Chinese patients. Journal of Medical Genetics. 2019;56(6):380–7. https://doi.org/10.1136/jmedgenet-2018-105567
4. Binderup MLM, Smerdel M, Borgwadt L, Nielsen SSB, Madsen MG, Møller HU, et al. von Hippel-Lindau disease: Updated guideline for diagnosis and surveillance. European Journal of Medical Genetics. 2022;65(8):104538. https://doi.org/10.1016/j.ejmg.2022.104538
5. Assouad J, Banu E, Brian E, Pham DN, Dujon A, Foucault C, et al. Strategies and outcomes in pulmonary and extrapulmonary metastases from renal cell cancer. European Journal of Cardio-Thoracic Surgery. 2008;33(5):794–8. https://doi.org/10.1016/j.ejcts.2008.01.045
6. Wang J, Zhang L, Qiu J, Li Z, Wu Y, Zhang C, et al. Natural history of von Hippel-Lindau disease-associated and sporadic clear cell renal cell carcinoma: A comparative study. Journal of Cancer Research Clinical Oncology. 2021;148(10):2631–41. https://doi.org/10.1007/s00432-021-03806-0
7. Lee H, Lee JK, Kim K, Kwak C, Kim HH, Byun SS, et al. Risk of metastasis for T1a renal cell carcinoma. World Journal of Urology. 2016;34(4):553–9. https://doi.org/10.1007/s00345-015-1659-4
8. Kato T, Wang C, Masumori N, Yamasaki T, Matsumoto H, Baba M, et al. T1a renal cell carcinoma with metastasis: Japanese society of renal cancer retrospective multi-institute results. Anticancer Research. 2023;43:4061–5. https://doi.org/10.21873/anticanres.16595
9. Toyoda T, Suzuki H, Nakajima T, Iwata T, Matsuoka A, Nishikimi K, et al. Successful diagnosis of an occult fallopian tube carcinoma detected from the diaphragm metastasis. General Thoracic and Cardiovascular Surgery. 2018;66(8):484–7. https://doi.org/10.1007/s11748-017-0881-y
10. Abu-Hijleh MF, Habbal OA, Moqattash ST. The role of the diaphragm in lymphatic absorption from the peritoneal cavity. Journal of Anatomy. 1995;186 (Pt 3):453–67.
11. Gruzdev IS, Blokhin IA, Lednev AN, Pechetov AA, Makov MA, Esakov YS, et al. Metastasis of endometrial cancer to right hemidiaphragm: A case report. International Journal of Surgery Case Reports. 2019; 60:363–7. https://doi.org/10.1016/j.ijscr.2019.06.028
12. Ota H, Kawai H, Yagi N, Ogawa J. Successful diagnosis of diaphragmatic solitary fibrous tumor of the pleura by preoperative ultrasonography. General Thoracic Cardiovascular Surgery. 2010;58(9):485–7. https://doi.org/10.1007/s11748-009-0551-9