Bilateral metachronous colon cancer metastasis to kidneys: A rare case with a treatment dilemma

Colorectal cancer continues to remain one of the most common and lethal cancers, with well-established locations for metastases to the liver, lung, and peritoneum. Improved chemotherapy regimens have resulted in patients with advanced disease experiencing prolonged survival resulting in these patients experiencing new atypical locations for metastases. We report the first case of primary colorectal carcinoma metachronously metastasizing to the kidneys bilaterally in a patient who presented with stage II colorectal cancer 8 years prior to kidney metastasis. The appropriate management of patients with renal lesions in the setting of advanced systemic disease may be challenging. Treatment should be based on preventing dialysis dependence during palliative therapy, performing potentially curative surgery in the setting of decreased systemic disease after neoadjuvant chemotherapy, and providing options for palliative intervention for the symptomatic patient.