Nouh Mohammed Ahmed Abdel-Muneem, Inui Masashi, Sugimoto Mikio, Kakehi Yoshiyuki, Yasukawa Akihiro
Department of Urology, Kagawa University, Faculty of Medicine, Kagawa, Japan.
Int J Urol. 2007 Oct;14(10):957-9. doi: 10.1111/j.1442-2042.2007.01884.x.
Tumor thrombus formation is a unique aspect of renal cell carcinoma with significant therapeutic and prognostic implications. The prognostic significance of cephalad extent of tumor thrombi to the right atrium remains controversial. Extended surgical removal, however, is the only way to expect survival. In 1989, a 40-year-old man was diagnosed with an advanced renal cell carcinoma (T(3C)N(2)M(0)) involving perinephric fat, hilar and para-aortic lymph nodes and a tumor thrombus extending to the right atrium. He was treated with extensive surgical resection of the tumor and its lymphatic and vascular extensions. Interferon-alpha injections were given for 2.5 years as an adjuvant immunotherapy. The patient was annually checked with abdominal ultrasound, chest X-ray and computed tomography, but has manifested no local or distant metastasis for 18 years. To our knowledge, this is the first reported case of extensive surgery on advanced renal cell carcinoma with no evidence of recurrence for 18 years.
肿瘤血栓形成是肾细胞癌的一个独特方面，具有重要的治疗和预后意义。肿瘤血栓向上延伸至右心房的预后意义仍存在争议。然而，扩大手术切除是有望实现生存的唯一途径。1989年，一名40岁男性被诊断为晚期肾细胞癌（T(3C)N(2)M(0)），累及肾周脂肪、肾门和主动脉旁淋巴结以及延伸至右心房的肿瘤血栓。他接受了肿瘤及其淋巴和血管延伸部分的广泛手术切除。给予α干扰素注射2.5年作为辅助免疫治疗。每年对该患者进行腹部超声、胸部X线和计算机断层扫描检查，18年来未出现局部或远处转移。据我们所知，这是首例报道的对晚期肾细胞癌进行广泛手术且18年无复发证据的病例。
