Waleczek Helfried, Wente Moritz-N, Kozianka Jürgen
Department of Surgery, Evangelic Hospital, Bredenscheider Strasse 54, D-45525 Hattingen. Germany.
World J Gastroenterol. 2005 Sep 21;11(35):5571-2. doi: 10.3748/wjg.v11.i35.5571.
We report a case of a 77-year-old female with a local recurrence of cancer after right hemicolectomy which infiltrated the pancreatic head affording pancreatoduodenectomy, who developed 3 years later recurrent tumor masses localized in the mesentery of the jejunum and in the lower pole of the left kidney. Partial nephrectomy and a segment resection of the small bowel were performed. Histological examination of both specimens revealed a necrotic metastasis of the primary carcinoma of the colon. Although intraluminal implantation of colon cancer cells in the renal pelvic mucosa from ureteric metastasis has been described, metastasis of a colorectal cancer in the kidney parenchyma is extremely rare and can be treated in an organ preserving manner. A complex pattern of colon cancer recurrence with unusual and rare sites of metastasis is reported.
我们报告一例77岁女性患者，在右半结肠切除术后癌症局部复发，肿瘤浸润胰头，遂行胰十二指肠切除术，3年后在空肠系膜和左肾下极出现复发性肿瘤肿块。进行了部分肾切除术和小肠节段切除术。对两个标本的组织学检查均显示为结肠癌原发灶的坏死转移。虽然已有输尿管转移导致结肠癌细胞在肾盂黏膜腔内种植的报道，但结直肠癌转移至肾实质极为罕见，且可采用保留器官的方式进行治疗。本文报道了结肠癌复发并伴有不寻常和罕见转移部位的复杂情况。
