Anyone with experience with trachea mets from Renal Cancer?

Dear “Penitent”

We are sorry that cancer has touched your family as it has for so many on this site, but that’s why we are here trying to be a help and comfort to others.  We certainly can sympathize and empathize with you and your son-in-law and his family. 

Most often all our friends here present with Esophageal Cancer that metastasizes to other major organs.  Personally, I don’t recall anyone writing in to say that their present diagnosis of esophageal cancer came from some other primary cancer. 

However, not that this helps, but in checking the web, I see at least 2 instances where Renal cancer had spread to the Esophagus or Stomach.  In another rare instance, it seems that Lung cancer had spread to the Esophagus.  It is usually just the opposite, and more often EC spreads to the Lung or to the kidney.

So just for the record, we don’t currently have anyone here with the same condition of your son-in-law.  However, from the references below, although RARE, it appears that it is possible to first have Renal cancer that spreads to the Esophagus.

Quality of life is what we Stage IV cancer patients seek for most.  As usual, we always suggest a SECOND opinion.  It gives clarity and peace of mind to the patient and his/her loved ones.  Quite naturally, we are hoping that the bronchoscopy results will help the doctors to reach the correct diagnosis.  We hope that some positive measures can be taken to help your son-in-law have a prolonged quality of life.    

Loretta

(Peritoneal Carcinomatosis/Ovarian Cancer Stage IV) & wife of William, a 15-yr. survivor of Esophageal Cancer, Stage III (T3N1M0) who had pre-op chemo/radiation then a Minimally Invasive Esophagectomy (MIE) performed by Dr. James D. Luketich at the University of Pittsburgh Medical Center on May 17, 2003. 

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1.     https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4297612/

Esophagus. 2015; 12(1): 91–94.

Published online 2014 Jan 8. doi:  10.1007/s10388-013-0411-7   PMCID: PMC4297612   PMID: 25620904

Esophageal metastasis of renal cancer 10 years after nephrectomy

Wataru Izumo, Masaho Ota, Kosuke Narumiya, Yushi Shirai, Kenji Kudo, andMasakazu Yamamoto - Author information ► Article notes ► Copyright and License information ► Disclaimer

Abstract   -  

The patient was a 65-year-old man, who had undergone right nephrectomy for renal cancer in 2002. At that time, histopathological examination revealed clear cell carcinoma (pT3a, pN0, M0, and pStage III).  Postoperatively, he received natural interferon alpha (6 million units 3 times a week) from November 2002 to February 2005, and showed no evidence of recurrence. However, he noticed dysphagia in March 2012. Endoscopy revealed a pedunculated polypoid tumor in the mid-esophagus and biopsies were taken showing a clear cell carcinoma. Contrast-enhanced thoracoabdominal CT scanning identified a pedunculated polypoid tumor in the mid-thoracic esophagus and enlargement of a lymph node adjacent to the right main bronchus. With a diagnosis of esophageal and lymph node metastases of renal cancer, the patient underwent esophagectomy with right thoracotomy with reconstruction by a posterior mediastinal stomach tube. Postoperative histopathological examination revealed clear cell carcinoma. Because esophageal metastasis of renal cancer is extremely rare, this case is reported here together with discussions of the relevant literature.

Keywords: Renal cancer, Esophageal metastasis, Surgery

Renal cell cancer is likely to hematogenously metastasize to the lung, bone, or liver, but metastasis to the esophagus is very rare.

We report a patient with esophageal and mediastinal lymph node metastases that were treated surgically 10 years after the resection of primary renal cancer.

Patient: A 65-year-old man.

Presenting complaint: difficulty in swallowing.

Past history

In 2002, the patient underwent right nephrectomy for renal cancer at another hospital. Histopathological examination revealed clear cell carcinoma (G2 > G3, pT3a, pN0, M0, and pStage III). Postoperative adjuvant therapy was performed with natural interferon alpha (Dainippon Sumitomo Pharma, Osaka, Japan) at a dose of 6 million units 3 times a week from 2002 to 2005, with no evidence of recurrence.

Present illness: in March 2012, the patient complained of dysphagia. Because upper gastrointestinal endoscopy detected a pedunculated polypoid tumor in the mid-esophagus and biopsy revealed clear cell carcinoma, he was referred to our hospital with a diagnosis of esophageal metastasis of renal cancer.

Findings on admission: the patient was 159 cm tall and weighed 51.8 kg. His temperature was 36.6 °C, blood pressure was 108/60 mmHg, and pulse rate was 77/min (regular). There was an upper abdominal scar from the transverse incision for his old right nephrectomy…”

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2.     https://www.ncbi.nlm.nih.gov/pubmed/25075797

• Format: Abstract

Anticancer Drugs. 2015 Jan;26(1):112-6. doi: 10.1097/CAD.0000000000000150.

Renal cell cancer metastases to esophagus and stomach successfully treated with radiotherapy and pazopanib.

Cabezas-Camarero S¹, Puente J, Manzano A, Corona JA, González-Larriba JL, Bernal-Becerra I, Sotelo M, Díaz-Rubio E. - Author information

 Abstract

Renal cell cancer has been rarely reported as a cause of gastric or esophageal metastases. They usually present with gastrointestinal bleeding and most cases have been managed surgically or endoscopically. We report the case of a 38-year-old man with a 4-year history of metastatic renal cell carcinoma admitted to the emergency room with melena and anemia.

At endoscopy, three esophageal polypoid lesions (middle and distal thirds) and a 7 cm mass in the gastric fundus were identified. Biopsy revealed esophageal mucosa infiltrated by renal cell carcinoma.

Radiotherapy was administered (30 Gy in 10 fractions), followed by pazopanib, with excellent tolerance and without new bleeding episodes.

Computed tomography scan showed complete disappearance of the esophageal and fundic lesions at 3 months follow-up. Twenty-four months after being initiated on pazopanib, there is no radiological evidence of disease. This is the first reported case showing complete remission of gastric and esophageal metastases after treatment with radiotherapy and pazopanib.

PMID: 25075797 DOI: 10.1097/CAD.0000000000000150 [Indexed for MEDLINE]

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3.     https://www.sciencedirect.com/science/article/pii/S1726490110700708

“CASE REPORT

Esophageal Metastasis From Occult Lung Cancer

Author links open overlay panelPo-KueiHsu^abcSen-EiShai^cdJohnWang^eChung-PingHsu^cd

 https://doi.org/10.1016/S1726-4901(10)70070-8Get rights and content

Under an Elsevier user license

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3a. http://www.jcma-online.com/article/S1726-4901(10)70070-8/pdf

Esophageal Metastasis From Occult Lung Cancer

 A 66-year-old man with dysphagia was found to have a poorly differentiated esophageal carcinoma by incision biopsy.

Following esophagectomy, reconstruction with a gastric tube was performed.

Pathological examination and immunohisto-chemistry showed infiltration of adenocarcinoma cells with positive thyroid transcription factor 1-staining in the submucosal layer, which indicated metastatic esophageal carcinoma.

Although no pulmonary lesion could be visualized by imaging or bronchoscopy, pulmonary origin was highly suspected as a result of positive thyroid transcription factor 1-staining.

To the best of our knowledge, this is the first reported case of metastatic esophageal carcinoma from occult lung cancer (AJCC TNM stage TX).”

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