Masuda Norihiko, Shiraishi Yusuke, Okubo Kazutoshi, Okada Takuya, Segawa Takehiko, Takada Mariko, Kawakita Mutsushi
The Department of Urology, Kobe City Medical Center General Hospital.
Hinyokika Kiyo. 2009 Feb;55(2):99-102.
We present a case of liver metastasis of renal cell carcinoma (RCC) presenting as an intraductal tumor thrombus of the common bile duct. A 62-year-old man was admitted with jaundice. He had undergone right nephrectomy for RCC 8 years previously, and had been administered interferon alfa for lung, bone, and liver metastases for these 3 years. Abdominal enhanced computerized tomography (CT) disclosed the progression of liver metastasis to the common bile duct and the dilated bilateral bile ducts. Endoscopic retrograde cholangiopancreatography (ERCP) revealed a smooth filling defect in an upper portion of the common bile duct, suggesting an intraductal RCC tumor thrombus of the common bile duct. He died 4 months later despite the percutaneous biliary drainage. Liver metastasis of RCC proceeding to the common bile duct is extremely rare, and this is the 8th case. We should be aware of the fact that metastatic intraductal tumor thrombus of the common bile duct can cause obstructive jaundice.
我们报告一例肾细胞癌（RCC）肝转移表现为胆总管内肿瘤血栓的病例。一名62岁男性因黄疸入院。他8年前因RCC接受了右肾切除术，并且在这3年中一直接受干扰素α治疗肺、骨和肝转移。腹部增强计算机断层扫描（CT）显示肝转移进展至胆总管以及双侧胆管扩张。内镜逆行胰胆管造影（ERCP）显示胆总管上部有光滑的充盈缺损，提示胆总管内RCC肿瘤血栓。尽管进行了经皮胆道引流，他仍在4个月后死亡。RCC肝转移进展至胆总管极为罕见，这是第8例。我们应该意识到胆总管转移性导管内肿瘤血栓可导致梗阻性黄疸这一事实。
