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肾细胞癌:胃转移肾细胞癌患者的完全病理缓解。

Renal cell carcinoma: complete pathological response in a patient with gastric metastasis of renal cell carcinoma.

机构信息

Medical Oncology Service, University Hospital Complex, A Coruña, Spain.

出版信息

Anticancer Drugs. 2010 Jan;21 Suppl 1:S13-5. doi: 10.1097/01.cad.0000361530.51675.60.

Abstract

A 75-year-old-man, with a 2-month history of abdominal pain, underwent a standard diagnostic workup that included a CT scan that showed a large right renal mass and subcentimeter nodes in the right and left lung lobes. In December 2003, the patient underwent right nephrectomy with adrenalectomy and a diagnosis of renal cell carcinoma (pT3N0M0 stage) was made. No further treatment was proposed and patient was followed up regularly. In October 2006, the annual gastrointestinal endoscopy showed asymptomatic multilobulated and polypoid masses in the gastric fundus and gastric body that corresponded to metastasis of the renal carcinoma that had been resected three years ago. Surgical treatment was refused and oral treatment with sunitinib (50 mg/day consecutively for 4 weeks followed by 2 weeks off) was initiated. Patient completed one cycle and development of acute toxicity (grade 3 asthenia, anorexia and mucositis) led to treatment interruption. After recovering from acute toxicity, the patient was proposed to reinitiate treatment with dose reduction, but he refused any medical treatment. At the follow-up visit, three months later, the gastrointestinal endoscopy showed four unspecific 2 mm nodules without malignant evidence. The whole-body CT did not reveal any other abnormality except for the known lung nodes. PET scan six months after treatment confirmed complete gastric response.

摘要

一位 75 岁男性,有 2 个月腹痛病史,进行了标准诊断性检查,包括 CT 扫描,显示右肾有一个大肿块,右肺和左肺叶有亚厘米大小的结节。2003 年 12 月,患者接受了右肾切除术和肾上腺切除术,诊断为肾细胞癌(pT3N0M0 期)。未提出进一步治疗方案,患者定期随访。2006 年 10 月,年度胃肠道内窥镜检查显示胃底部和胃体多发性、息肉样肿块,与三年前切除的肾癌转移相对应。手术治疗被拒绝,开始口服舒尼替尼(每天 50mg,连续服用 4 周,然后停药 2 周)。患者完成了一个周期,但出现急性毒性(3 级乏力、厌食和粘膜炎),导致治疗中断。急性毒性恢复后,建议患者减少剂量重新开始治疗,但他拒绝了任何药物治疗。在三个月后的随访中,胃肠道内窥镜检查显示四个无特异性的 2 毫米结节,无恶性证据。全身 CT 除了已知的肺结节外,没有发现其他异常。治疗后六个月的 PET 扫描证实了完全的胃部反应。

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