[Cerebral metastasis from a renal cell carcinoma more than 10 years after nephrectomy: report of two cases].

: The authors report two cases with renal cell carcinoma (RCC) metastatic to the brain more than 10 years after nephrectomy. Case 1: An eighty-six-year-old female, on whom nephrectomy had been performed 12 years before, complained of alexia. Computed tomography (CT) revealed ring enhancement in the left temporoparietal region. Total removal of the brain tumor and irradiation of 18 Gy during surgery was performed. Histological examination showed metastatic brain tumor from RCC. The postoperative course was excellent. In the postoperative examination lung metastasis was found. Case 2: A sixty-seven-year-old male, on whom nephrectomy had been performed 15 years before, presented with right hemiparesis, aphasia and convulsion. CT showed two enhanced lesions, one of which accompanied with a hematoma in the left frontal lobe. Chest X-ray showed a coin lesion in the right lower lobe. Total removal of brain tumors was performed and 18 Gy irradiation was administered during surgery. Histological study revealed RCC. However, 3 months after surgery, a new lesion was recognized in the opposite hemisphere. The long interval of latency may be attributed to the slow-growing characteristic of renal cell carcinoma and the fact that renal cell carcinoma is under the influence of host immunity. Surgical treatment is recommended for patients who develop a solitary metastatic lesion or in whom other lesions are controlled and remain in a stable condition.