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Extrarenal Papillary Renal Cell Carcinoma: A Unique Case With Bilateral Involvement of the Adrenal Glands

Year: 2026

Type: article

Abstract: Primary extrarenal renal cell carcinoma (RCC) is an exceptionally rare malignancy. We report a unique case of bilateral adrenal papillary extrarenal RCC in a 62-year-old man, managed through sequential surgical interventions over a prolonged follow-up. Initial right adrenalectomy revealed a papillary RCC with high-grade oncocytic features; immunohistochemical analysis confirmed PAX8 positivity, supporting a renal-type origin in the absence of a renal primary. Subsequent contralateral adrenal involvement and local recurrence required laparoscopic adrenalectomy and multiorgan resection. Despite complete macroscopic resections, the disease progressed to hepatic, pulmonary, peritoneal, and cerebral metastases, resulting in the patient's death due to postoperative intracranial hemorrhage. No renal involvement was identified throughout the disease course. This case highlights the aggressive behavior of extrarenal RCC and underscores the importance of comprehensive immunohistochemical workup, prolonged surveillance, and multidisciplinary management in the absence of standardized guidelines.

Source: Case Reports in Urology

DOI: 10.1155/criu/9413935