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Metastatic renal cell carcinoma presenting as multiple pleural tumours

Abstract:  A 66‐year‐old man was admitted with dyspnoea. Chest X‐ray and chest computed tomography (CT) demonstrated a left‐sided pleural effusion and multiple tumours, suggesting malignant mesothelioma in the left pleural space, but there were no pulmonary lesions. However, abdominal CT revealed a right renal tumour. An ultrasonography‐guided needle biopsy of the pleural mass provided evidence of metastatic renal cell carcinoma (RCC). The pleural lesions dramatically decreased in size following right radical nephrectomy and subsequent interferon‐α treatment. While the thorax is a frequently affected site of RCC, sole pleural metastases are rare and are often secondary to lung involvement. Batson's plexus, a network of vertebral valve‐less veins with multiple connections, is likely responsible for the contralateral pleural metastases of RCC.