Rare isolated synchronous splenic metastasis in a patient with type II papillary renal cell carcinoma

Metastatic disease is common in renal cell carcinoma (RCC), with a third of cases being synchronous. RCC is known to metastasize to any organ in the body; however, isolated splenic metastasis is extremely rare. We report a case of synchronous splenic metastasis from type II papillary RCC with 80% sarcomatoid change. He was successfully treated with a right radical nephrectomy with en-bloc right liver resection and splenectomy with negative margins to achieve removal of the primary tumour and complete metastasectomy. He underwent 6 cycles adjuvant chemotherapy with Gemcitabine. The patient developed disease recurrence in the spine at the 6th post-operative month with a pathological fracture at T3 and cord indentation for which he underwent posterior decompression and instrumentation and palliative radiotherapy. He recovered well and remains ambulant. Surveillance scans 16 months post-surgery revealed no tumour recurrence or new metastasis.