ArticleInternational journal of surgery case reports2026
Not all masses are metastases: a diagnostic dilemma resolved - synchronous HER2-positive breast cancer and renal oncocytoma.
Article in International journal of surgery case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: In oncology, the discovery of a synchronous renal mass during breast cancer staging often signifies metastatic disease, drastically altering prognosis and management. We present a critical case where this assumption was challenged by a rare benign entity, renal oncocytoma, highlighting a pivotal diagnostic crossroads. Case presentation: A 48-year-old woman presented with a right breast lump. Biopsy confirmed HER2-positive invasive carcinoma. Staging positron emission tomography computed tomography revealed an 18F- fluorodeoxyglucose (FDG)-avid left renal mass, highly suspicious for metastasis. A subsequent renal biopsy revealed an oncocytic neoplasm. This finding prompted a curative-intent strategy: the patient underwent simultaneous right breast-conserving surgery and left laparoscopic partial nephrectomy. Final histopathology confirmed stage pT1N0 breast cancer and renal oncocytoma. The patient recovered well and received adjuvant paclitaxel-based chemotherapy with trastuzumab, followed by radiation to the breast, and is planned for continuation of trastuzumab to complete 1 year of anti-HER2 therapy. At 6 months of follow-up, the patient remains asymptomatic with no clinical or radiological evidence of disease recurrence. Discussion: This case highlights a critical clinical caveat: benign lesions can masquerade as metastases. Our report describes the management of synchronous HER2-positive breast cancer and renal oncocytoma. It exemplifies how a biopsy-driven approach prevented unnecessary systemic therapy and radical nephrectomy, preserving renal function and upholding curative intent. Conclusion: This experience mandates that tissue confirmation of synchronous lesions be integral to staging protocols. Multidisciplinary review is indispensable for navigating such complex presentations and avoiding therapeutic misadventures.
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