Metastasis to the Bladder: A Rare Site of Recurrence of Renal Cell Carcinoma

Figure 2

H&E-stained sections from the radical nephrectomy showed (a) areas of classic low-grade clear cell renal cell carcinoma (40x) and (b) an exophytic nodule of tumor undermining ureteral epithelium (2x). (c) Higher magnification of tumor invading the ureteral wall shows higher grade nuclei and tumor cells with voluminous and focally eosinophilic cytoplasm undermining urothelium (20x). (d) Transurethral resection of the subsequent bladder tumor showed tumor morphologically identical to that seen in the nephrectomy depicted in panel (c), undermining benign urothelium. (e) PAX8 shows diffuse nuclear labeling consistent with renal cell carcinoma metastatic to the bladder (20x). (f) Subsequent ureteral resection showed clear cell renal cell carcinoma forming an intraluminal mass with benign urothelium above (10x). (g) Focal lymphovascular invasion was noted within the ureteral wall (10x).

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