Abdominal Radiology

, Volume 42, Issue 5, pp 1510–1516 | Cite as

Abdominal seeding of renal cell carcinoma: radiologic, pathologic, and prognostic features

  • Seung Hyun Park
  • Young Taik Oh
  • Dae Chul Jung
  • Nam Hoon Cho
  • Young Deuk Choi
  • Sung Yoon ParkEmail author



We analyzed radiologic and histologic characteristics, and prognosis of abdominal seeding from renal cell carcinoma (RCC).


Consecutive 25 patients with RCC and histologically or radiologically diagnosed abdominal seeding were analyzed. No patient had another type of malignancy. Histologic subtype, Fuhrman grade, sarcomatoid differentiation, and T-stage of primary tumors were assessed. Pre- or postoperative presentation of seeding was investigated. Median survival time and RCC-specific survival rates were evaluated.


Of 25 patients, 15 (60%) died and 4 (16%) were hopelessly discharged (median follow-up time, 6 months; range 1–62 months). Histologic subtypes were clear cell (76%, 19/25), papillary (16%, 4/25), chromophobe (4%, 1/25), and poorly differentiated (4%, 1/25). Fuhrman grades were 4 (48%, 12/25), 3 (36%, 9/25), 2 (12%, 3/25), and unknown (4%, 1/25). T-stage of the four patients with grade 2 or unknown was 3a. Sarcomatoid differentiation and postoperative occurrence were found in 32% (8/25) and 80% (20/25), respectively. Median survival time was 13 months, and 1-year, 2-year, and 3-year RCC-specific survival rates were 51%, 41%, and 31%, respectively.


Abdominal seeding may occur in various subtypes of RCC with high Fuhrman grade including sarcomatoid differentiation or high T-stage, and appears to be related to poor prognosis.


Renal cell carcinoma Seeding Carcinomatosis Implant Prognosis 


Compliance with ethical standards


This research was supported by a faculty research grant of Yonsei University College of Medicine for 2015 (6-2015-0052).

Conflict of interest

Dae Chul Jung has received a faculty research grant of Yonsei University College of Medicine for 2015 (6-2015-0052). The other authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Statement of informed consent was not applicable since the manuscript does not contain any patient data.


  1. 1.
    Ljungberg B, Bensalah K, Canfield S, et al. (2015) EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol 67(5):913–924CrossRefGoogle Scholar
  2. 2.
    Thompson RH, Atwell T, Schmit G, et al. (2015) Comparison of partial nephrectomy and percutaneous ablation for cT1 renal masses. Eur Urol 67(2):252–259CrossRefGoogle Scholar
  3. 3.
    Flanigan RC, Mickisch G, Sylvester R, et al. (2004) Cytoreductive nephrectomy in patients with metastatic renal cancer: a combined analysis. J Urol 171(3):1071–1076CrossRefGoogle Scholar
  4. 4.
    Heng DY, Wells JC, Rini BI, et al. (2014) Cytoreductive nephrectomy in patients with synchronous metastases from renal cell carcinoma: results from the International Metastatic Renal Cell Carcinoma Database Consortium. Eur Urol 66(4):704–710CrossRefGoogle Scholar
  5. 5.
    Dabestani S, Marconi L, Hofmann F, et al. (2014) Local treatments for metastases of renal cell carcinoma: a systematic review. Lancet Oncol 15(12):e549–561CrossRefGoogle Scholar
  6. 6.
    Ko JJ, Xie W, Kroeger N, et al. (2015) The International Metastatic Renal Cell Carcinoma Database Consortium model as a prognostic tool in patients with metastatic renal cell carcinoma previously treated with first-line targeted therapy: a population-based study. Lancet Oncol 16(3):293–300CrossRefGoogle Scholar
  7. 7.
    Bianchi M, Sun M, Jeldres C, et al. (2012) Distribution of metastatic sites in renal cell carcinoma: a population-based analysis. Ann Oncol 23(4):973–980CrossRefGoogle Scholar
  8. 8.
    Weiss L, Harlos JP, Torhorst J, et al. (1988) Metastatic patterns of renal carcinoma: an analysis of 687 necropsies. J Cancer Res Clin Oncol 114(6):605–612CrossRefGoogle Scholar
  9. 9.
    Bush WH Jr, Burnett LL, Gibbons RP (1977) Needle tract seeding of renal cell carcinoma. AJR Am J Roentgenol 129(4):725–727CrossRefGoogle Scholar
  10. 10.
    Tartar VM, Heiken JP, McClennan BL (1991) Renal cell carcinoma presenting with diffuse peritoneal metastases: CT findings. J Comput Assist Tomogr 15(3):450–453CrossRefGoogle Scholar
  11. 11.
    Stavropoulos NJ, Deliveliotis C, Kouroupakis D, et al. (1995) Renal cell carcinoma presenting as a large abdominal mass with an extensive peritoneal metastasis. Urol Int 54(3):169–170CrossRefGoogle Scholar
  12. 12.
    Chen P, Middlebrook MR, Goldman SM, et al. (1998) Sister Mary Joseph nodule from metastatic renal cell carcinoma. J Comput Assist Tomogr 22(5):756–757CrossRefGoogle Scholar
  13. 13.
    Akhavein A, Neuberger MM, Dahm P (2012) Tumour-seeding: a rare complication of ablative therapy for clinically localised renal cell carcinoma. BMJ Case Rep 2012:bcr2012006948CrossRefGoogle Scholar
  14. 14.
    Esnakula AK, Naab TJ, Green W, et al. (2013) Extensive peritoneal carcinomatosis secondary to renal cell carcinoma with sarcomatoid and rhabdoid differentiation. BMJ Case Rep 2013:bcr2013008725PubMedPubMedCentralGoogle Scholar
  15. 15.
    Mullins JK, Rodriguez R (2013) Renal cell carcinoma seeding of a percutaneous biopsy tract. Can Urol Assoc J 7(3–4):E176–179CrossRefGoogle Scholar
  16. 16.
    Ploumidis A, Panoskaltsis T, Gavresea T, et al. (2013) Tumor seeding incidentally found two years after robotic-Assisted radical nephrectomy for papillary renal cell carcinoma. A case report and review of the literature. Int J Surg Case Rep 4(6):561–564CrossRefGoogle Scholar
  17. 17.
    Sainani NI, Tatli S, Anthony SG, et al. (2013) Successful percutaneous radiologic management of renal cell carcinoma tumor seeding caused by percutaneous biopsy performed before ablation. J Vasc Interv Radiol 24(9):1404–1408CrossRefGoogle Scholar
  18. 18.
    Giorgadze T, Qureshi F, Jacques SM, et al. (2013) Retroperitoneal recurrence of a stage 1 renal cell carcinoma 4 years following core biopsy and fine needle aspiration: possible needle tract seeding. Diagn Cytopathol 41(5):474CrossRefGoogle Scholar
  19. 19.
    Goncalves MO, Benidir T, Erbano BO, et al. (2014) Peritoneal metastases from renal cell carcinoma: Images in urology. Can Urol Assoc J 8(5–6):E391–392CrossRefGoogle Scholar
  20. 20.
    Win AZ, Aparici CM (2014) Omental nodular deposits of recurrent chromophobe renal cell carcinoma seen on FDG-PET/CT. J Clin Imaging Sci 4:51CrossRefGoogle Scholar
  21. 21.
    Pilanci KN, Ordu C, Akpinar H, et al. (2014) Dramatic Response to Catumaxomab Treatment for Malign Ascites Related to Renal Cell Carcinoma With Sarcomatoid Differentiation. Am J TherGoogle Scholar
  22. 22.
    Chang DT, Sur H, Lozinskiy M, et al. (2015) Needle tract seeding following percutaneous biopsy of renal cell carcinoma. Korean J Urol 56(9):666–669CrossRefGoogle Scholar
  23. 23.
    Soares D, Ahmadi N, Crainic O, et al. (2015) Papillary renal cell carcinoma seeding along a percutaneous biopsy tract. Case Rep Urol 2015:925254PubMedPubMedCentralGoogle Scholar
  24. 24.
    Yuksel OH, Yildirim C, Urkmez A, et al. (2015) Contralateral tumor seeding of renal cell carcinoma mimicking late metastasis of liver after laparoscopic nephrectomy: A case report with review of the literature. Arch Ital Urol Androl 87(3):256–257CrossRefGoogle Scholar
  25. 25.
    Brufau BP, Cerqueda CS, Villalba LB, et al. (2013) Metastatic renal cell carcinoma: radiologic findings and assessment of response to targeted antiangiogenic therapy by using multidetector CT. Radiographics 33(6):1691–1716CrossRefGoogle Scholar
  26. 26.
    Dromain C, Leboulleux S, Auperin A, et al. (2008) Staging of peritoneal carcinomatosis: enhanced CT vs PET/CT. Abdom Imaging 33(1):87–93CrossRefGoogle Scholar
  27. 27.
    Cheville JC, Lohse CM, Zincke H, et al. (2004) Sarcomatoid renal cell carcinoma: an examination of underlying histologic subtype and an analysis of associations with patient outcome. Am J Surg Pathol 28(4):435–441CrossRefGoogle Scholar
  28. 28.
    Shuch B, Amin A, Armstrong AJ, et al. (2015) Understanding pathologic variants of renal cell carcinoma: distilling therapeutic opportunities from biologic complexity. Eur Urol 67(1):85–97CrossRefGoogle Scholar
  29. 29.
    Delahunt B, Cheville JC, Martignoni G, et al. (2013) The International Society of Urological Pathology (ISUP) grading system for renal cell carcinoma and other prognostic parameters. Am J Surg Pathol 37(10):1490–1504CrossRefGoogle Scholar
  30. 30.
    Shinagare AB, Vikram R, Jaffe C, et al. (2015) Radiogenomics of clear cell renal cell carcinoma: preliminary findings of The Cancer Genome Atlas-Renal Cell Carcinoma (TCGA-RCC) Imaging Research Group. Abdom Imaging 40(6):1684–1692CrossRefGoogle Scholar
  31. 31.
    Khor LY, Dhakal HP, Jia X, et al. (2016) Tumor necrosis adds prognostically significant information to grade in clear cell renal cell carcinoma: a study of 842 consecutive cases from a single institution. Am J Surg Pathol 40(9):1224–1231CrossRefGoogle Scholar
  32. 32.
    Jamshidi N, Jonasch E, Zapala M, et al. (2015) The radiogenomic risk score: construction of a prognostic quantitative, noninvasive image-based molecular assay for renal cell carcinoma. Radiology 277(1):114–123CrossRefGoogle Scholar
  33. 33.
    Eggener SE, Yossepowitch O, Pettus JA, et al. (2006) Renal cell carcinoma recurrence after nephrectomy for localized disease: predicting survival from time of recurrence. J Clin Oncol 24(19):3101–3106CrossRefGoogle Scholar
  34. 34.
    Naito S, Yamamoto N, Takayama T, et al. (2010) Prognosis of Japanese metastatic renal cell carcinoma patients in the cytokine era: a cooperative group report of 1463 patients. Eur Urol 57(2):317–325CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Seung Hyun Park
    • 1
  • Young Taik Oh
    • 1
  • Dae Chul Jung
    • 1
  • Nam Hoon Cho
    • 2
  • Young Deuk Choi
    • 3
  • Sung Yoon Park
    • 1
    Email author
  1. 1.Department of Radiology and Research Institute of Radiological ScienceYonsei University College of MedicineSeoulRepublic of Korea
  2. 2.Department of PathologyYonsei University College of MedicineSeoulRepublic of Korea
  3. 3.Department of UrologyYonsei University College of MedicineSeoulRepublic of Korea

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