Ueno Yoko, Ishikawa Masakuni, Tsuruta Takashi, Wajiki Masahisa
Department of Urology, Shinonoi General Hospital.
Nihon Hinyokika Gakkai Zasshi. 2008 Mar;99(3):560-4. doi: 10.5980/jpnjurol1989.99.560.
A 28-year-old woman presented with right flank pain. A large, firm, fixed mass was palpable in the right side of the abdomen. Computed tomography revealed a solid mass of the right kidney with extension into the renal vein and inferior vena cava. The patient underwent right radical nephrectomy with en bloc resection of the inferior vena cava containing tumor thrombus and right adrenalectomy. Histologically the tumor consisted of small tumor cells with rosette formation. Immunohistochemical staining was positive for CD99 and NSE. Analysis with polymerase chain reaction (PCR) demonstrated the EWS/FLI1 fusion products resulting from a chromosomal translocation. These findings were consistent with primary renal primitive neuroectodermal tumor (PNET). Two months after surgery, multiple lung, liver and lymph node metastases were found. The patient received 2 cycles of chemotherapy with cisplatin, ifosfamide, etoposide, resulting in a partial remission. She subsequently received 1 cycle chemotherapy with paclitaxel and carboplatin, resulting in no response. The metastatic lung and liver diseases progressed and she died 5 months after diagnosis.
一名28岁女性因右侧胁腹疼痛就诊。在其右侧腹部可触及一个大的、质地坚硬、固定的肿块。计算机断层扫描显示右肾有一个实性肿块,并延伸至肾静脉和下腔静脉。患者接受了右肾根治性切除术,同时整块切除包含肿瘤血栓的下腔静脉,并进行了右侧肾上腺切除术。组织学检查显示肿瘤由形成玫瑰花结的小肿瘤细胞组成。免疫组化染色CD99和NSE呈阳性。聚合酶链反应(PCR)分析显示存在由染色体易位导致的EWS/FLI1融合产物。这些发现符合原发性肾原始神经外胚层肿瘤(PNET)。术后两个月,发现多处肺、肝和淋巴结转移。患者接受了2个周期的顺铂、异环磷酰胺、依托泊苷化疗,部分缓解。随后她接受了1个周期的紫杉醇和卡铂化疗,无反应。转移性肺和肝脏疾病进展,患者在诊断后5个月死亡。