Metachronous Unilateral Ovarian Metastasis from Renal Cell Carcinoma with Chemotherapy Response: A Case Report

Renal cell carcinoma (RCC) rarely metastasizes to the ovary, with only a few dozen cases reported in the literature. We report a rare case of a 23-year-old woman who initially presented with a large left renal mass and underwent radical nephrectomy. Histopathological and immunohistochemical analysis confirmed unclassified clear renal adenocarcinoma. After completing six cycles of chemotherapy and three years of regular follow-up, a left adnexal mass was detected. Imaging and core biopsy confirmed metastatic ovarian involvement with histologic features identical to the primary renal tumor. The patient responded favorably to a second chemotherapy course, and laparoscopic oophorectomy revealed no residual malignancy. This case emphasizes the importance of long-term surveillance in RCC patients and highlights the diagnostic challenge posed by rare metastatic presentations mimicking primary ovarian tumors. Awareness of such rare pathways is essential for timely diagnosis, proper therapeutic decisions, and improved patient outcomes through multidisciplinary collaboration.