Surgical treatment of a rare primary renal carcinoid tumor with liver metastasis

Carcinoid tumors are characteristically low grade malignant neoplasms with neuroendocrine differentiation that arise in various body sites, most commonly the lung and gastrointestinal tract, but less frequently the kidneys, breasts, ovaries, testes, prostate and other locations. We report a case of a carcinoid of renal origin with synchronous single liver metastases on radiological studies.Case presentationA 45 year-old patient who presented with abdominal pain was found on CT scan to have lesions in the right ovary, right kidney, and left hepatic lobe.

CA-125, CEA, and CA 19-9 were within normal limits, as were preoperative liver function tests and renal function. Biopsy of the liver mass demonstrated metastatic neuroendocrine tumor.

At laparotomy, the patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, radical right nephrectomy with lymphadenectomy, and left hepatectomy. Pathology evaluation reported a right ovarian borderline serous tumor, well-differentiated neuroendocrine carcinoma of the kidney (carcinoid) with 2 positive retroperitoneal lymph nodes, and a single liver metastasis.

Immunohistochemistry revealed that this lesion was positive for synaptophysin and CD56, but negative for chromogranin as well as CD10, CD7, and CD20, consistent with a well-differentiated neuroendocrine tumor. She is doing well one year after her initial surgery, with no evidence of tumor recurrence.

Conclusion: Early surgical intervention, together with careful surveillance and follow-up, can achieve successful long-term outcomes in patients with this rare malignancy.

Author: Roberto Gedaly, Hoonbae Jeon, Thomas D Johnston, Patrick P McHugh, Randall G Rowland and Dinesh Ranjan
Credits/Source: World Journal of Surgical Oncology 2008, 6:41

Published on: 2008-04-22

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Comments Page 1 of 1

Jerri Sue

Posted 653 days ago

I have primary renal carcinoid with mets to the liver, hips and 3 vertebrae. Sounds like this patient was lucky!!!!

Jim W.

Posted 657 days ago

Very dissapointing that someone would publish a "study" based upon a single patient case, especially to characterize "successful long term outcomes". This patient will require following for many years (probably at least 5 to 10) to make such a determination, due to the nature of typical NETs. With liver mets already occurring, there are likely more micro mets in the body and other parts of the liver.
Want accurate information? Go to www.carcinoid.org
Thank you.

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