Mori N, Tei N, Kakimoto K, Hara T, Koide T
Department of Urology, Osaka Kosei-Nenkin Hospital.
Hinyokika Kiyo. 1999 May;45(5):343-7.
Since solitary metastatic renal tumors are not commonly diagnosed before death, the conclusive treatment of the metastatic renal tumor has not been established. We report three cases of metastatic renal tumors and discuss the indication of surgical therapy for metastatic renal tumors. The first case was in a 64-year-old male who underwent esophagectomy for squamous cell carcinoma. Seven months after the operation, a right renal tumor was found. The second case was in a 63-year-old male who underwent right upper pneumonectomy for adenocarcinoma with a right renal tumor, which seemed to be a solitary metastasis. The third case was in a 69-year-old male who underwent right pneumonectomy for adenocarcinoma. One month after the initial operation, a left renal cystic tumor was found. Since, in all cases, the tumors seemed to be solitary metastatic renal tumors without any other metastatic lesions, nephrectomy was performed. Unfortunately, however, the nephrectomy did not improve prognosis and all three patients did within 10 months after the nephrectomy. Nephrectomy may not be recommended in cases of metastatic renal tumors even if no other metastatic lesions can be found by various image examinations.
由于孤立性转移性肾肿瘤在患者生前通常难以确诊,因此转移性肾肿瘤的确切治疗方法尚未确立。我们报告三例转移性肾肿瘤病例,并探讨转移性肾肿瘤手术治疗的适应证。第一例是一名64岁男性,因鳞状细胞癌接受了食管切除术。术后七个月,发现右肾肿瘤。第二例是一名63岁男性,因腺癌接受了右上肺叶切除术,同时发现右肾有肿瘤,似乎是孤立性转移瘤。第三例是一名69岁男性,因腺癌接受了右肺叶切除术。初次手术后一个月,发现左肾囊性肿瘤。由于在所有病例中,肿瘤似乎都是孤立性转移性肾肿瘤,且无任何其他转移病灶,因此均进行了肾切除术。然而,不幸的是,肾切除术并未改善预后,所有三名患者均在肾切除术后10个月内死亡。即使通过各种影像学检查未发现其他转移病灶,转移性肾肿瘤病例也可能不建议进行肾切除术。