腹腔镜下部分肾切除术后切口部位复发及局部区域转移1例。
A case of port-site recurrence and locoregional metastasis after laparoscopic partial nephrectomy.
作者信息
Masterson Timothy A, Russo Paul
机构信息
Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
出版信息
Nat Clin Pract Urol. 2008 Jun;5(6):345-9. doi: 10.1038/ncpuro1127. Epub 2008 May 20.
BACKGROUND
A 63-year-old man underwent hand-assisted laparoscopic partial nephrectomy for a 4.5 cm right renal mass, pathologically confirmed as type 2 papillary renal cell carcinoma (RCC). Two years later he was referred to a specialist oncology center after routine follow-up raised suspicion for metastatic disease.
INVESTIGATIONS
Physical examination, CT, PET, laboratory analysis of blood and stool samples, fine needle aspiration of the hand-assist site, and colonoscopy with biopsy.
DIAGNOSIS
Locoregional metastatic papillary RCC with port-site metastasis.
MANAGEMENT
The patient underwent excision of his port-site and intra-abdominal recurrences, right hemicolectomy and cholecystectomy. Pathologic examination revealed metastatic papillary RCC at all sites. After a disease-free interval of 12 months, the patient was found to have radiographic evidence of recurrent disease in the liver and peritoneum.
背景
一名63岁男性因右肾4.5厘米肿块接受了手辅助腹腔镜下部分肾切除术，病理证实为2型乳头状肾细胞癌（RCC）。两年后，在常规随访引发对转移性疾病的怀疑后，他被转诊至一家专业肿瘤中心。
检查
体格检查、CT、PET、血液和粪便样本的实验室分析、手辅助部位的细针穿刺活检以及结肠镜检查并活检。
诊断
局部区域转移性乳头状RCC伴端口部位转移。
治疗
患者接受了端口部位和腹腔内复发灶切除、右半结肠切除术和胆囊切除术。病理检查显示所有部位均为转移性乳头状RCC。在无病间隔12个月后，发现患者肝脏和腹膜有影像学复发证据。
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