[Renal cell carcinoma with many transvenous pleural metastases]

A 64-year-old man was admitted to our hospital because of abnormal shadows on chest X-ray films. Malignant mesothelioma was suspected. However a CT scan revealed a large mass in the right kidney and many nodules in the liver and pleura. This suggested that primary renal cell carcinoma had metastasized to the liver and pleura. The patient was treated with transarterial embolization (TAE), alpha and gamma interferon, and UFT, but died of respiratory failure caused by massive bleeding from the pleural metastases. At autopsy, renal cell carcinoma, clear cell subtype, was noted. The many pleural lesions were of the same histologic type, which suggested that they were metastases from the kidney. Renal cell carcinoma frequently metastasizes to the lungs or bones via the arteries. However, many pleural metastases without lung metastasis is rare. We report a case of renal cell carcinoma with many pleural metastases via Batson's venous plexus.