Gammon Bryan Leigh, Gleason Briana C, Thomas Antoinette B, Cibull Thomas Lee
Department of Dermatology, Northwestern University, Chicago, IL 60611, USA.
J Cutan Pathol. 2010 Dec;37(12):1255-8. doi: 10.1111/j.1600-0560.2010.01578.x.
Metastasis stemming from a distant malignancy is far less common than an oropharyngeal primary and represents only 1% of all oral neoplasms. The difficulty in diagnosing a metastasis in the oropharynx may be compounded if the lesion is poorly differentiated and bears little resemblance to the primary tumor. We present the case of synchronous metastatic renal cell carcinoma of the mandibular gingiva in a woman with sarcomatoid clear cell renal cell carcinoma. The metastatic lesion was poorly differentiated and lacked expression of the renal cell carcinoma (RCC) antigen. In contrast, PAX-8 staining was strongly positive. This case serves to highlight the diagnostic difficulty posed by poorly differentiated lesions in the oropharynx and reinforces the sensitivity of the cell lineage-specific transcription factor PAX-8 in poorly differentiated RCC.
源自远处恶性肿瘤的转移远比口咽原发性肿瘤少见，仅占所有口腔肿瘤的1%。如果病变分化差且与原发性肿瘤几乎没有相似之处，那么口咽转移瘤的诊断难度可能会增加。我们报告了一例患有肉瘤样透明细胞肾细胞癌的女性患者，其下颌牙龈同时发生转移性肾细胞癌。转移瘤分化差，缺乏肾细胞癌（RCC）抗原表达。相比之下，PAX-8染色呈强阳性。该病例凸显了口咽中分化差的病变所带来的诊断困难，并强化了细胞谱系特异性转录因子PAX-8在低分化RCC中的敏感性。
