Renal cell carcinoma with atypical metastases sites revealed by diabetes mellitus: a case report

Abstract Background : Metastatic renal cancer represents 13.3% of all kidney cancers. Lung, bone, lymph nodes and liver are the most common metastatic sites. Incidental discovery of renal tumor disease interests 36% of patients with stage IV. This observation presents a particular circumstance of renal tumor discovery and unusual metastatic sites.Case presentation : We report the case of a 64-year-old woman recently diagnosed with diabetes mellitus. An uro-CT scan had shown a polymetastatic left renal tumor with unusual metastatic sites: parietal pleura, pancreas, and contralateral kidney. The patient underwent a biopsy of the thoracic parietal nodule. The pathology report concluded to the diagnosis of a pleural metastasis from a clear cell renal cell carcinoma (ccRCC). She had a targeted therapy. At the last follow-up dating from 3 months after admission, the patient had altered general condition associated with total hematuria.Conclusions : Parietal pleura, pancreas, and contralateral kidney are rare secondary sites of RCC. The clinical expression of metastatic invasion of the pancreas can rarely fit with diabetes. Metastatic dissemination to these organs is most often associated with an unfavorable prognosis.