Male patient aged 59 years with a history of chronic obstructive pulmonary disease and right lower lobectomy six months ago for squamous cell carcinoma of the lung (T2N0M0) at the reference centre, without having received any subsequent treatment. No known allergies or other history of interest.
He consulted for clinical manifestations compatible with left renal colic of moderate intensity with ureteral irradiation, without voiding syndrome and accompanied by haematuria with emission of filiform clots.
He reported having lost approximately 8 kg in the last 2 months.
Examination revealed a slight mucocutaneous pallor, slightly positive left fist percussion. The abdomen was soft and depressible with no masses or megaliths. The rest of the examination was of no interest.
Haematological examination showed mild anaemia, with normal biochemistry and coagulation.
The urine sediment showed microscopic haematuria.
Ultrasound showed a cortical cyst in the upper pole of the left kidney measuring 5 cm in size and a solid-cystic tumour of the same size in the lower pole without ectasia of the excretory tract. The right kidney, bladder and prostate were normal.
Given the suspicion of a renal mass versus a complex renal cyst, it was decided to perform a thoraco-abdominal-minopelvic CAT scan, which revealed post-surgical changes in the left lung with bilateral emphysema. Retroperitoneal adenopathies in the aorto-caval territory measuring over 1 cm in diameter and a heterogeneous renal mass measuring 5 cm in diameter.

With these findings and the suspicion of renal carcinoma vs. metastasis, it was decided to perform a directed CT FNA, which obtained squamous cells from the left kidney.

With the diagnosis of left renal metastasis of pulmonary squamous cell carcinoma (Stage IV), it was decided to refer the patient to the Medical Oncology Department.
He started treatment with Cisplatin 75 mg/m2 and Vinorelbine 25 mg/m2 on the first and eighth day of every 21 days, until 3 cycles were completed, and then a response evaluation study was carried out. After receiving 3 cycles of chemotherapy with cisplatin-vinorelbine, a discrete growth of the renal mass was observed, so it was considered that there was no response. For this reason she started a second line of chemotherapy with docetaxel 100mg/m2 every 21 days, of which she has received 3 cycles. She is awaiting a CT scan to evaluate the response and, depending on the results, a PET scan has been considered to decide on a possible surgical approach to the renal lesion, if there are no new pathological foci.
In any case, the prognosis is the same as for any metastatic pulmonary neoplasm.