Description
The specimen consists of a left hemisected kidney. This is markedly enlarged and the upper pole is
extended by a tumour mass. The tumour is irregular, being yellow in colour. The central portion of
the tumour is necrotic with focal areas of fibrosis, cyst formation and haemorrhage. The tumour
extends through the renal capsule and is present immediately adjacent to the renal pelvis. The
features are typical of a primary renal cell carcinoma. Also included in the specimen is a block
dissection consisting of the tongue, larynx with vocal chords and adjacent tissues. Three separate
tumour nodules are identified. The largest of these is situated in the supraglottic region and appears
as a semispherical mass up to 3 cm in diameter. Two further tumour nodules are present in the right
and left pyriform sinuses. Histologic examination of these tumours showed them to be clear cell
carcinomas and similar in character to the primary renal cell carcinoma found in the left kidney.
History
This 66-year-old woman presented with a left thyroid swelling and voice change, and was
found on examination to have paralysis of the left vocal chord. Hemithyroidectomy was undertaken
and a clear cell carcinoma consistent with a renal primary was found. Further investigation showed a
large retroperitoneal mass arising from the upper pole of the left kidney. Tumour recurrence in the
vicinity of the larynx necessitated tracheostomy. The patient remained relatively well for 18 months
then rapidly deteriorated and died. Bronchopneumonia was found at postmortem examination.