Chuang Xue En, Loh Hwai Liang, Sim Hong Gee, Fong Kah Leng, Tan Min-Han
Department of Medical Oncology, National Cancer Centre Singapore, Singapore.
J Med Case Rep. 2011 Apr 1;5:131. doi: 10.1186/1752-1947-5-131.
Laparoscopic port-site metastasis is a rare but well recognized outcome following surgery in urological cancers, with its etiology not clearly understood. Additionally, vaginal metastasis in clear cell renal cell carcinoma is rare, and has not been previously reported in the setting of papillary renal cell carcinoma.
We present the case of a 71-year-old Chinese woman with metastatic type II papillary renal cell carcinoma with histologically verified vaginal involvement and a concurrent laparoscopic port-site metastasis. This was also associated with a unique constellation of widely disseminated metastatic sites, which include a local relapse, the peritoneum and the urethra.
Laparoscopic port-site metastases are associated with the presence of advanced cancer with multiple sites of metastasis. We hypothesize from the findings of our report and background data that this phenomenon is more likely to be related to tumor factors rather than operative factors. We also present what is, to the best of our knowledge, the first reported case in the literature of vaginal and urethral metastasis and the second reported case of laparoscopic port-site recurrence.
腹腔镜手术穿刺部位转移是泌尿生殖系统癌症手术后一种罕见但已被充分认识的结果,其病因尚不清楚。此外,透明细胞肾细胞癌发生阴道转移很罕见,而乳头状肾细胞癌发生阴道转移此前未见报道。
我们报告了一名71岁中国女性,患有II型乳头状肾细胞癌伴组织学证实的阴道转移及同时发生的腹腔镜手术穿刺部位转移。该病例还伴有广泛播散转移灶的独特组合,包括局部复发、腹膜和尿道转移。
腹腔镜手术穿刺部位转移与存在多处转移的晚期癌症有关。根据我们报告的研究结果及背景数据,我们推测这种现象更可能与肿瘤因素而非手术因素有关。据我们所知,我们还报告了文献中首例阴道和尿道转移病例以及第二例腹腔镜手术穿刺部位复发病例。