Leptomeningeal Metastases in Renal Cell Carcinoma at Initial Diagnosis: 2 Case Reports and Literature Review

Cancer Invest. 2019;37(9):501-505. doi: 10.1080/07357907.2019.1662031. Epub 2019 Oct 4.

Abstract

Leptomeningeal metastasis (LM) in solid tumors are rare, even more in renal cell carcinoma (RCC). To date there is a lack of consensual treatment modalities of leptomeningeal metastasis. Furthermore, with the improvement of outcomes and more effective systemic targeted therapies, the management of leptomeningeal metastasis becomes a real challenge. We here report two cases of RCC with leptomeningeal metastasis at initial diagnosis. Both patients had concurrent adjacent skull bone metastasis. Therapeutic management of both patients consisted in surgical resection, followed by radiotherapy in one case. Systemic treatment was delayed according to current recommendations for the management of metastatic RCC. The aim of this work is to report the therapeutic approach and related outcomes and also provide a review of the currently available literature on leptomeningeal disease in renal cell carcinoma. Indeed, local treatment with curative outcome of meningeal location in RCC should be performed specially in LM at initial diagnosis.

Keywords: Renal cell carcinoma; clinical management; leptomeningeal metastasis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Brain / diagnostic imaging
  • Brain / pathology
  • Carcinoma, Renal Cell / diagnostic imaging*
  • Carcinoma, Renal Cell / drug therapy
  • Carcinoma, Renal Cell / radiotherapy
  • Combined Modality Therapy
  • Humans
  • Kidney Neoplasms / diagnostic imaging*
  • Kidney Neoplasms / drug therapy
  • Kidney Neoplasms / radiotherapy
  • Male
  • Meningeal Neoplasms / diagnostic imaging
  • Meningeal Neoplasms / radiotherapy
  • Meningeal Neoplasms / secondary*
  • Meningeal Neoplasms / surgery
  • Middle Aged
  • Skull Neoplasms / radiotherapy
  • Skull Neoplasms / secondary*
  • Skull Neoplasms / surgery
  • Sunitinib / therapeutic use
  • Treatment Outcome

Substances

  • Sunitinib