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Renal Metastases

Renal metastases are secondary tumors in the kidney that originate from nonrenal primary tumors.

Epidemiology

Renal metastases are rare in clinical practice but are found much more frequently in autopsy series of patients with metastatic cancer. Important primary tumor sites include the lung, breast, gastrointestinal tract, head and neck, and thyroid; lymphomas are also a source.

Clinical Presentation and Diagnosis

Renal metastases are usually asymptomatic and are discovered incidentally on imaging. CT or MRI typically shows multifocal renal lesions and extensive extrarenal metastatic disease. Solitary renal metastases can occur; in these cases, differentiating them from renal cell carcinoma may be difficult.

Renal biopsy:

Biopsy is appropriate when histologic confirmation would affect treatment, particularly for an indeterminate solitary renal mass, a known extrarenal primary tumor, or before nonsurgical local or systemic treatment when the diagnosis has not been confirmed histologically.

Treatment

Management focuses on systemic treatment of the primary tumor or best supportive care. Embolization or nephrectomy may rarely be considered for palliative reasons.

References

  Deutsche Version: Nierenmetastasen

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