case_images: PMC10758902_01
case_images: CT image on admission. (a) A 4 x 4 cm mass is visible on the right thoracic wall. (b) A mass is seen on both adrenal glands. (c) A tumor with contrast enhancement and irregular margins is visible on the left kidney.
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case_images: Based on contrast-enhanced CT, the patient was diagnosed with renal cell carcinoma with a right-sided thoracic wall and bilateral adrenal metastases (Fig. 1).
case_images: Pathology results. (a-f) Pathological results show atypical cell growth in cords and alveoli within the fibrous connective tissue with partial tube formation. Tumor cells are highly polymorphic (a). CK7 was positive (b). GATA-3 was negative (c), indicating that urothelial carcinoma was unlikely. E-cadherin (d), EMA (e), and CD10 (f) were positive, indicating a high probability of CDC.
case_images: IJU5-7-50-g001.jpg
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case_images: The patient underwent a right-sided thoracic wall metastasis biopsy and was diagnosed with CDC (Fig. 2) and referred to our department.
case_images: CT image 4 months after treatment. All tumor shrinkage was observed in the right thoracic wall (a), both adrenal glands (b), and the left kidney(c). We evaluated PR using RECIST 1.1.
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case_images: The greatest tumor shrinkage was observed 4 months after treatment initiation, during which we evaluated PR (Fig. 3).
case_images: CT image on 7 months after treatment. The right thoracic wall metastasis (a) and the left kidney tumor (c) were enlarged. Both adrenal metastasis (b) remained unchanged in size. We evaluated PD using RECIST 1.1.
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case_images: PMC10758902_01_IJU5-7-50-g004.jpg
case_images: iju512666-fig-0004
case_images: Although shrinkage was maintained for several months, tumor growth was observed and evaluated PD at 7 months after treatment initiation, which we evaluated PD (Fig. 4).