Metastatic Myoepithelioma in a Solitary Kidney Treated with Laparoscopic Microwave Ablation

Case Report

Austin J Urol. 2015;2(3): 1026.

Metastatic Myoepithelioma in a Solitary Kidney Treated with Laparoscopic Microwave Ablation

Feng T¹*, Dru CJ¹, Gershman A¹ and Julien P²

¹Division of Urology, Cedars-Sinai Medical Center, USA

²Department of Radiology, Cedars-Sinai Medical Center, USA

*Corresponding author: Feng T, Division of Urology,Cedars-Sinai Medical Center, 8635 West Third Street,Suite 1070 West, Los Angeles, CA 90048, USA

Received: February 05, 2015; Accepted: April 17, 2015; Published: April 21, 2015

Abstract

Myoepithelioma is a rare entity and represents less than 1% of soft tissue tumors. We present a rare case of myoepithelioma that has metastasized to the kidney and was treated successfully with laparoscopic microwave ablation.

Keywords: Microwave ablation; Laparoscopic; Kidney; Myoepithelioma

Abbreviations

MRI: Magnetic Resonance Imaging

Case Presentation

Myoepithelioma is a rare entity and represents less than 1% of soft tissue tumors [1]. They commonly occur in salivary glands but have also been reported in the larynx, breast, and bone [2]. Genitourinary involvement by myoepithelioma is even rarer and to date, only one case report of myoepithelioma in the kidney has been documented [3].

We present a case of a 47-year-old female with metastatic myoepithelioma to the kidneys. The patient initially presented with a soft tissue mass in the right foot at the age of 20. The biopsy of the mass resulted in a tumor of myoepithelioma of soft tissue of uncertain malignant potential. She underwent wide resection of the primary lesion and did well until 2011, at which time she was diagnosed with a right kidney mass along with several lung lesions. She underwent a right radical nephrectomy and subsequent thoracoscopic wedge resections of the lung nodules. Pathology of the renal specimen and lung nodules were similar to that of the foot . Thus, it was concluded that they all represented malignant myoepithelioma. She was then followed every 3 months with chest and abdominal imaging to evaluate for recurrences.

Since 2011, she has developed new metastatic lesions in her lungs and solitary left kidney. Of note, she has never had any symptoms attributed to her disease. Given that she has a solitary kidney, ablation of these renal and the lung lesion was recommended. In 2013, she underwent microwave ablation of the left lung mass as well as two left kidney lesions. One year later, she presented with a new 1-cm lesion near the left renal hilum seen on MRI (Figure 1a). Given the need for nephron sparing,another ablation procedure was recommended. However, given the location of the tumor, there was concern for potential thermal injury to the collecting system from a percutaneous method. A laparoscopic exposure of the renal system with concomitant microwave ablation was then chosen.

Citation: Feng T, Dru CJ, Gershman A and Julien P. Metastatic Myoepithelioma in a Solitary Kidney Treated with Laparoscopic Microwave Ablation. Austin J Urol. 2015;2(3): 1026. ISSN:2472-3606