Clear Cell Renal Cell Carcinoma Involving Intrarenal Adrenal Tissue: A Rare Case With Staging Implications

TL;DR

A rare case of kidney cancer involving adrenal tissue is presented, emphasizing the need for accurate diagnosis to avoid incorrect staging.

Contribution

This case highlights the diagnostic challenge of distinguishing ectopic adrenal tissue from adrenal-renal fusion in renal cell carcinoma.

Findings

Clear cell renal cell carcinoma was found infiltrating adrenal tissue confined to the kidney capsule.

Radiologic and histopathologic analysis confirmed ectopic adrenal tissue rather than fused tissue.

Accurate staging requires integrating radiologic and histopathologic findings.

Abstract

The presence of intrarenal adrenal tissue is a rare finding that complicates the staging of renal cell carcinoma, particularly in distinguishing between adrenal-renal fusion and ectopic adrenal remnants. These conditions, though rare, have unique implications for tumor staging and management. We present a case of a 47-year-old woman with a lesion of the right kidney incidentally discovered during imaging for ulcerative colitis. Histopathology revealed clear cell renal cell carcinoma infiltrating adrenal tissue confined to the kidney capsule, with no lymphovascular or perirenal fat invasion. Radiologic correlation indicated ectopic rather than fused adrenal tissue. Failure to correctly classify the presence of adrenal involvement could result in incorrect staging of the carcinoma, highlighting the importance of integrating histopathologic and radiologic findings in accurate diagnosis and management.

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