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Abstract: SA-PO094

Kidney Failure Requiring Dialysis due to Renal Metastatic Spread from a Laryngeal Squamous Cell Carcinoma

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Ayasse, Niklas, Universitatsklinikum Mannheim, Mannheim, Baden-Württemberg, Germany
  • Marinez, Julian, Universitatsklinikum Mannheim, Mannheim, Baden-Württemberg, Germany
  • Daschner, Clara, Universitatsklinikum Mannheim, Mannheim, Baden-Württemberg, Germany
  • Popovic, Zoran, Universitatsklinikum Mannheim, Mannheim, Baden-Württemberg, Germany
  • Lammert, Anne, Universitatsklinikum Mannheim, Mannheim, Baden-Württemberg, Germany
  • Krämer, Bernhard K., Universitatsklinikum Mannheim, Mannheim, Baden-Württemberg, Germany
Introduction

Renal metastatic spread from laryngeal squamous cell carcinoma (SCC) is particularly rare. We here report the unique case of a patient with acute dialysis requiring renal failure due to diffuse metastatic spread of a laryngeal SCC.

Case Description

A 59-year-old man presented with progressive dyspnea, and anuria. His past medical history was remarkable for right sided supraglottic laryngeal cancer cT3cN2bcM0 diagnosed two and a half years earlier. The histopathological work-up had revealed a squamous cell carcinoma (SCC). A radiochemotherapy had been effectuated and the patient had since then been in remission.

The initial diagnostic workup revealed acute kidney failure AKIN-3. Initially, a prerenal cause was assumed. Bedside sonography did not show urinary retention. Due to uremia symptoms intermittent hemodialysis was initiated. Since renal function did not improve, a percutaneous kidney biopsy was obtained. The histopathological work-up revealed squamous cell carcinoma infiltrates consistent with renal metastasis from the supraglottic laryngeal carcinoma (Figure 1). The neighboring healthy renal parenchyma showed only few vital glomeruli, without any signs of glomerular damage. We hence concluded that the origin of the kidney failure was a diffuse renal metastatic spread from the primary cancer. Due to persistent anuria, a tunneled dialysis catheter was placed and the patient was started on intermittent hemodialysis thrice a week.

Discussion

To the best of our knowledge, only 3 previous cases of renal metastasis from laryngeal SCC have been described in the literature (Paul, Harden et al. 1999, Lecoeuvre, Degardin et al. 2003, Erbag et al. 2013). In contrast to these previous reports dealing with unilateral renal metastasis, our patient case is unique in the way that both kidneys were diffusely infiltrated by metastasis, that led to end-stage kidney disease.
This case report highlights that one should always consider renal metastasis as a cause of acute kidney failure in tumor patients.