Lin Chin-Yew, Lee Chiung-Tsung, Huang Jen-Seng, Chang Liang-Che
Department of Pathology, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC.
Chang Gung Med J. 2003 Jul;26(7):525-9.
Metastases of renal pelvic transitional cell carcinoma (TCC) to the skin and subcutaneous tissues are extremely rare. Similar to metastases from other genitourinary tract organs, they commonly affect middle-aged or elderly men, generally herald a rapid progression, and are associated with a poor outcome. Skin metastatic lesions present as painful or nontender nodules, and a vascular or even a zosteriform appearance may occasionally be noted. The latter is often confused with herpes zoster infection. The diagnosis is usually confirmed by histopathological findings of biopsy specimens. Cutaneous metastases generally carry a dismal prognosis, with survival of only several months. We herein present a case of renal pelvic TCC with cutaneous metastases to the bilateral arms and epigastric region 1.5 years after diagnosis of the primary lesion. The patient's condition rapidly deteriorated, and she expired 4 weeks later. We present this rare case to highlight the possibility of cutaneous metastases from renal pelvis TCC and with the hope to increase awareness of the rapidly fatal course of such patients.
肾盂移行细胞癌(TCC)转移至皮肤和皮下组织极为罕见。与其他泌尿生殖道器官的转移相似,它们通常累及中年或老年男性,一般预示着病情快速进展,且预后不良。皮肤转移病灶表现为疼痛或无压痛的结节,偶尔可见血管样甚至带状疱疹样外观。后者常与带状疱疹感染相混淆。诊断通常通过活检标本的组织病理学检查结果得以证实。皮肤转移通常预后不佳,生存期仅数月。我们在此报告一例肾盂TCC患者,在原发性病变诊断1.5年后出现双侧手臂和上腹部皮肤转移。患者病情迅速恶化,4周后死亡。我们呈现这一罕见病例以强调肾盂TCC发生皮肤转移的可能性,并希望提高对此类患者快速致命病程的认识。