Late recurrence of chromophobe renal cell carcinoma to unusual sites after 12 years of radical nephrectomy and radiotherapy: a rare case report from Syria

Abstract

Introduction and Importance: In 2020, renal cell carcinoma (RCC) had an incidence of 73 750 new cases. This cancer is well known for its ability to give early and late metastases to some usual and unusual sites. The term ‘late recurrence’ is widely used to indicate a period exceeding 10 years from curative nephrectomy. This not-understood behaviour is almost specific to RCC, and it happens in a range between 4.3 and 11% of cases of RCC. Case Presentation: We report a case of a 67-year-old nonalcoholic smoker Syrian male presented with a 2-month painful mass located at the left upper posterolateral abdominal wall’s region. He has had a history of left chromophobe cell RCC treated with radical nephrectomy with adjuvant radiotherapy for 12 years. In light of computed tomography’s findings, a surgical biopsy was performed, and a pathological and immunohistochemical examination confirmed the diagnosis of chromophobe RCC. Clinical Discussion: Malignant cells seeding the surgical cut path and staying dormant for 12 years is the best theory of many to explain our case. Conclusion: We reported evidence for the potential of a relatively indolent histologic type of RCC (i.e. chromophobe cell carcinoma) to cause late recurrence after 12 years to a very rare site (i.e. abdominal wall’s superficial muscles). Research should focus on addressing late recurrence to determine the best surveillance protocols; investigating malignant cells seeding during surgery to improve surgical oncology’s outcomes; and studying late recurrence’s genetics to boost our targeted therapy options.