Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Tumours
Abstract number: 25160
SOLITARY PATELLA METASTASIS FROM RENAL CELL CARCINOMA; A RARE
CASE REPORT
Peter RALTE, Ahsan AKHTAR, Naveen VASIREDDY, Steven KERSHAW
Macclesfield District General Hospital, Macclesfield (UNITED KINGDOM)
We report a rare case of a solitary metastatic lesion to the patella in a 74 year old
male who was subsequently diagnosed with renal cell carcinoma (RCC).The patient
presented to our clinic in May 2009 with a 12 month history of left anterior knee pain.
X-ray revealed a large osteolytic lesion and an associated pathological fracture.
Subsequent investigations demonstrated a large mass arising from the upper pole of
the left kidney. Metastatic lesions were found bilaterally in both lungs and adrenal
glands and a smaller metastatic / synchronous lesion was found in the right kidney.
Due to the advanced stage of the disease and the associated short life expectancy, a
decision to treat our patient conservatively was made.Excluding leukaemias, the
most common form of bone neoplasm is metastatic carcinoma. Tumours of the
patella are extremely rare and account for less than 1% of primary bone tumours.
Patella tumours are unique in that primary neoplasms, the majority of which are
benign, are far more common than metastatic lesions.There have been 25 cases of
patella metastases documented in English literature. Of these, our case represents
the fourth to originate from a RCC. This case demonstrates the atypical nature in
which RCC may first present with up to 30% of patients presenting with metastases.
Importantly, this case highlights the need to consider other less obvious causes in
the differential diagnosis of anterior knee pain, particularly in the elderly patient
where such symptoms may be attributed to osteoarthritis.
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