肾细胞癌导致的阴道转移和血小板减少症。
Vaginal metastasis and thrombocytopenia from renal cell carcinoma.
作者信息
Allard Jay E, McBroom John W, Zahn Christopher M, McLeod David, Maxwell G Larry
机构信息
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Walter Reed Army Medical Center and the National Naval Medical Center, Washington, DC, USA.
出版信息
Gynecol Oncol. 2004 Mar;92(3):970-3. doi: 10.1016/j.ygyno.2003.11.046.
BACKGROUND
Vaginal cancer represents approximately 1-2% of genital tract malignancies. Most cases represent metastasis from the cervix, endometrium, or colon. Metastasis of renal cell carcinoma to the vagina is extremely rare.
CASE
A 58-year-old female presented with a bleeding vaginal lesion. Laboratory studies revealed severe thrombocytopenia, and radiological studies revealed a left renal mass; excision was consistent with metastatic renal cell carcinoma. A subsequent nephrectomy confirmed renal cell carcinoma. Postoperatively, the patient underwent immunotherapy and the thrombocytopenia resolved.
CONCLUSION
We report the first case of metastatic renal cell carcinoma presenting as a vaginal metastasis with thrombocytopenia as a paraneoplastic manifestation. Renal cell carcinoma must be in the differential diagnosis of a clear cell neoplasm in a postmenopausal woman, particularly with systemic symptoms suggestive of a paraneoplastic syndrome.
背景
阴道癌约占生殖道恶性肿瘤的1%-2%。大多数病例是宫颈癌、子宫内膜癌或结肠癌的转移。肾细胞癌转移至阴道极为罕见。
病例
一名58岁女性出现阴道出血性病变。实验室检查显示严重血小板减少，影像学检查发现左肾肿物；切除物与转移性肾细胞癌相符。随后的肾切除术证实为肾细胞癌。术后，患者接受免疫治疗，血小板减少症得以缓解。
结论
我们报告了首例以阴道转移为表现且伴有血小板减少这一肿瘤旁分泌表现的转移性肾细胞癌病例。对于绝经后女性的透明细胞肿瘤，尤其是伴有提示肿瘤旁分泌综合征的全身症状时，肾细胞癌必须纳入鉴别诊断。
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