Kidney tumor

Other tumors


Deputy Editor-in-Chief: Debra L. Zynger, M.D.
Nicole K. Andeen, M.D.
Maria Tretiakova, M.D., Ph.D.

Last author update: 24 January 2022
Last staff update: 24 January 2022

Copyright: 2003-2023,, Inc.

PubMed Search: "kidney metastases"

Nicole K. Andeen, M.D.
Maria Tretiakova, M.D., Ph.D.
Page views in 2022: 1,344
Page views in 2023 to date: 344
Cite this page: Andeen NK, Tretiakova M. Metastases. website. Accessed April 1st, 2023.
Definition / general
  • Malignant neoplasm metastatic to kidney, not of primary renal or renal pelvis origin
  • Most are carcinomas (80.8%)
    • Primary site (BJU Int 2016;117:775)
      • Usually lung (43.7%)
      • Colorectal (10.6%)
      • ENT (6%)
      • Breast (5.3%)
      • Soft tissue (5.3%)
      • Thyroid (5.3%)
  • Also melanoma, pancreas, ovary, testis
Essential features
  • In surgical pathology based studies, metastasis to kidney is uncommon; usually recognized after the diagnosis of primary tumor and may not be seen until long after that diagnosis
Clinical features
  • Presents with flank pain (30%), hematuria (16%) and weight loss (12%) (BJU Int 2016;117:775)
  • Often solitary (77%), although most later develop more sites of metastasis (BJU Int 2016;117:775)
  • 88% diagnosed after primary tumor, 9% concurrent with primary; in 2% the metastasis to kidney preceded diagnosis of primary tumor (Histopathology 2015;66:587)
  • In 19%, there is a > 10 year interval between time of diagnosis of primary tumor and diagnosis of kidney metastasis (Histopathology 2015;66:587)
  • 37% of patients have no other known metastasis at time of diagnosis (Histopathology 2015;66:587)
  • Renal cell carcinoma is the most common recipient of tumor to tumor metastasis in malignant tumors (Urology 1987;30:35)
Radiology description
  • Compared with renal primaries, more often solid and endophytic; no difference in tumor size, polar predominance or CT enhancement patterns (AJR Am J Roentgenol 2011;197:W680)
Radiology images

Images hosted on other servers:

Metastatic oral squamous cell carcinoma

Metastatic phyllodes tumor

Prognostic factors
  • In a series of 151 patients with tumors metastatic to kidney, median overall survival from time of metastatic diagnosis was 1.1 years and median overall survival from primary tumor diagnosis was 3 years (BJU Int 2016;117:775)
Case reports
  • May be treated with ablation or resection
Gross description
Gross images

Contributed by Debra Zynger, M.D.

Lung squamous cell carcinoma

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Small cell lung cancer

Solitary fibrous tumor

Microscopic (histologic) description
  • Varies; may mimic urothelial carcinoma with divergent differentiation or unusual primary kidney tumors
Microscopic (histologic) images

Contributed by Maria Tretiakova, M.D., Ph.D., Nicole K. Andeen, M.D.

Breast carcinoma

Gastric carcinoma

Well differentiated neuroendocrine tumor

Cytology description
Negative stains
  • Renal cell carcinoma markers: PAX8 (83% of renal cell carcinomas are positive), EMA (78% of clear cell renal cell carcinomas are positive), CAIX (87% of clear cell renal cell carcinoma are positive), hKIM-1 (human kidney injury molecule-1) (83% of clear cell renal cell carcinoma are positive), PAX2, renal cell carcinoma (Am J Surg Pathol 2011;35:678)
Molecular / cytogenetics description
  • Molecular testing not currently used consistently; diagnosis is based on history, morphology and IHC
Differential diagnosis
Board review style question #1
Which is the most useful immunohistochemical panel to differentiate adrenal cortical carcinoma from clear cell renal cell carcinoma?

  1. Inhibin, calretinin, CD10, PAX2
  2. MelanA, CK7, RCC, PAX2
  3. SF1, calretinin, CAIX, PAX8
  4. SF1, CK7, RCC, CD10
Board review style answer #1
C. SF1, calretinin, CAIX, PAX8

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Reference: Metastases to kidney
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