{
  "abstract": "Primary extrarenal renal cell carcinoma (RCC) is an exceptionally rare malignancy. We report a unique case of bilateral adrenal papillary extrarenal RCC in a 62-year-old man, managed through sequential surgical interventions over a prolonged follow-up. Initial right adrenalectomy revealed a papillary RCC with high-grade oncocytic features; immunohistochemical analysis confirmed PAX8 positivity, supporting a renal-type origin in the absence of a renal primary. Subsequent contralateral adrenal involvement and local recurrence required laparoscopic adrenalectomy and multiorgan resection. Despite complete macroscopic resections, the disease progressed to hepatic, pulmonary, peritoneal, and cerebral metastases, resulting in the patient's death due to postoperative intracranial hemorrhage. No renal involvement was identified throughout the disease course. This case highlights the aggressive behavior of extrarenal RCC and underscores the importance of comprehensive immunohistochemical workup, prolonged surveillance, and multidisciplinary management in the absence of standardized guidelines.",
  "abstract_shown": true,
  "affiliations": [
    "Urology Department Almada-Seixal Local Health Unit Garcia de Orta Hospital Almada Portugal hgo.pt.",
    "Surgery Department Almada-Seixal Local Health Unit Garcia de Orta Hospital Almada Portugal hgo.pt.",
    "Pathology Department Almada-Seixal Local Health Unit Garcia de Orta Hospital Almada Portugal hgo.pt.",
    "Radiology Department Almada-Seixal Local Health Unit Garcia de Orta Hospital Almada Portugal hgo.pt.",
    "Medical Oncology Department Almada-Seixal Local Health Unit Garcia de Orta Hospital Almada Portugal hgo.pt."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Margarida André",
      "orcid": "0000-0002-5918-8621"
    },
    {
      "affs": [
        1
      ],
      "name": "Brigitta Cismasiu",
      "orcid": "0000-0001-7573-4410"
    },
    {
      "affs": [
        0
      ],
      "name": "Luísa Moreira"
    },
    {
      "affs": [
        0
      ],
      "name": "Marta Vasconcelos",
      "orcid": "0000-0003-0623-9920"
    },
    {
      "affs": [
        0
      ],
      "name": "Maria Isabel Santos"
    },
    {
      "affs": [
        2
      ],
      "name": "João Rodrigues-Alves"
    },
    {
      "affs": [
        3
      ],
      "name": "Eduardo Fernandes",
      "orcid": "0009-0004-2064-7159"
    },
    {
      "affs": [
        0
      ],
      "name": "João Paulo Rosa"
    },
    {
      "affs": [
        0
      ],
      "name": "Miguel Carvalho"
    },
    {
      "affs": [
        4
      ],
      "name": "Helder Mansinho"
    },
    {
      "affs": [
        1
      ],
      "name": "Carlos Luz-Correia",
      "orcid": "0000-0002-2363-9670"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fk923wmemrz56.bib",
  "cited_by": 0,
  "doi": "10.1155/criu/9413935",
  "fulltext_url": "https://europepmc.org/articles/PMC13741139",
  "id": "fk923wmemrz56",
  "issns": [
    "2090-696X",
    "2090-6978"
  ],
  "landing_url": "https://europepmc.org/article/MED/42997264",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2730|Renal cell carcinoma treatment"
    ]
  ],
  "openalex": "W7225374170",
  "pdf_url": "https://europepmc.org/articles/PMC13741139?pdf=render",
  "pmcid": "PMC13741139",
  "pmid": "42997264",
  "published": "2026-11-06",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/fk923wmemrz56.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T15:20:34Z",
      "native_id": "MED:42997264",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42997264"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Renal cell carcinoma treatment",
      "subfield": "oncology"
    }
  ],
  "title": "Extrarenal Papillary Renal Cell Carcinoma: A Unique Case With Bilateral Involvement of the Adrenal Glands.",
  "title_text": "Extrarenal Papillary Renal Cell Carcinoma: A Unique Case With Bilateral Involvement of the Adrenal Glands.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T15:20:34Z",
  "url": "https://research.draconitic.com/paper/fk923wmemrz56",
  "venue": "Case reports in urology",
  "versions": []
}