Late multiple pleural metastases of renal cell carcinoma.

A 64-year-old man was admitted to our hospital due to dyspnea. He had a history of renal cell carcinoma (RCC) and had undergone radical left nephrectomy 23 years earlier. A chest X-ray showed a right pleural effusion. After a trocar tube was inserted, plain computed tomography of the chest revealed small masses (Picture 1). Diagnostic thoracoscopy disclosed a small, white mass on the pleura (Picture 2). A histopathological examination confirmed a diagnosis of metastatic renal cell carcinoma, demonstrating tumor cells with abundant clear cytoplasm and small, round, centrally located nuclei strongly expressing CD10 (Picture 3). Enhanced abdominal CT showed no new lesions in the residual kidney. The patient was diagnosed as having late multiple pleural metastases of RCC. Physicians should consider the possibility of late recurrence when confronted with a patient with pulmonary lesions and a history of RCC (1, 2).